1. Home
  2. Directory
  3. Connecticut
  4. Southbury
  5. Podiatrist
  6. NPI Profile

ODIN DE LOS REYES DPM INC
NPI 1205050630
Podiatrist - Primary Podiatric Medicine in Southbury, CT

Active since April 13, 2007
1 POMPERAUG OFFICE PARK, SUITE 105, SOUTHBURY, CT 06488(230) 262-6100(203) 264-6679 Get Directions Write a Review

NPPES record last updated: September 23, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 23, 2020, Nov 22, 2019 (2 updates tracked since 2019).

About Odin De Los Reyes Dpm Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ODIN DE LOS REYES DPM INC (NPI 1205050630) is a healthcare organization registered as a primary podiatric medicine in Southbury, Connecticut and active in the NPI registry since April 2007. The organization maintains a secondary practice location in Farmington and lists Odin Anthony De Los Reyes, Podiatrist, as its authorized official.

NPPES Registry Identity

NPI1205050630
Entity TypeOrganization
Primary Taxonomy213EP1101X
Legal Business NameODIN DE LOS REYES DPM INC
Location Address1 POMPERAUG OFFICE PARK, SUITE 105Southbury, CT 06488-2295
Mailing Address1 Pomperaug Office Park, Suite 105Southbury, CT 06488-2295 · (230) 262-6100 · Fax (203) 264-6679
Phone(230) 262-6100
Fax(203) 264-6679
Organization SubpartNo
Authorized OfficialOdin Anthony De Los ReyesPodiatrist · (203) 262-6100
Enumeration DateApril 13, 2007
Last NPPES UpdateSeptember 23, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 23, 2020
✔ NPI 1205050630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Primary Podiatric MedicinePodiatric Medicine & Surgery Service Providers
Taxonomy Code213EP1101X
License✔ Licensed in CT · CT000680
1 POMPERAUG OFFICE PARK, Southbury, CT 06488
Open in Google Maps ↗

Secondary Practice Location 1

Location 1325 Main St Ste 1BFarmington, CT 06032-2977 · Phone (860) 229-1999 · Fax (203) 264-6679

Other Identifiers 1

Medicaid004186947CT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Odin De Los Reyes Dpm Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Odin De Los Reyes DPM Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Odin De Los Reyes, D.P.M
Podiatry
NPI 1679682249
1 POMPERAUG OFFICE PARK SUITE 105
Southbury, CT 06488
(203) 262-6100
✔ PECOS✔ Accepts Medicare1.3 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Odin De Los Reyes Dpm Inc's NPI number?

The NPI number for Odin De Los Reyes Dpm Inc is 1205050630. It was assigned to this organization in the NPPES registry on April 13, 2007.

Where is Odin De Los Reyes Dpm Inc located?

Odin De Los Reyes Dpm Inc is located at 1 Pomperaug Office Park Suite 105, Southbury, CT 06488. The listed phone number is (230) 262-6100.

What is Odin De Los Reyes Dpm Inc's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Primary Podiatric Medicine, with taxonomy code 213EP1101X.

Is Odin De Los Reyes Dpm Inc enrolled in Medicare?

Yes. Odin De Los Reyes Dpm Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Odin De Los Reyes Dpm Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Odin De Los Reyes Dpm Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Odin De Los Reyes Dpm Inc was last updated on September 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.