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REYNALDO L REYES JR. PHYSICIAN ASSISTANT
NPI 1306800644
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Active since April 13, 2006PECOS Enrolled
35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MARINE CORPS RECRUIT DEPOT, SAN DIEGO, CA 92140(619) 532-4056 Get Directions Write a Review

NPPES record last updated: September 22, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Reynaldo L Reyes Jr. Physician Assistant NPPES

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

REYNALDO L REYES JR. PHYSICIAN ASSISTANT (NPI 1306800644) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306800644
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameREYNALDO L REYES JR.Credential: PHYSICIAN ASSISTANT
Location Address35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MARINE CORPS RECRUIT DEPOTSan Diego, CA 92140
Mailing Address12497 Conquistador WaySan Diego, CA 92128-2152 · (858) 603-3106
Phone(619) 532-4056
Sole ProprietorYes
Enumeration DateApril 13, 2006
Last NPPES UpdateSeptember 22, 2022
NPPES CertifiedSeptember 22, 2022
✔ NPI 1306800644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition
A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 58601 (CA)
35000 GUADALCANAL ST, San Diego, CA 92140
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Reynaldo L Reyes Jr. Physician Assistant is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. RODEN ROSARIO QUIBUYEN PA-C
Military Health Care Provider
35000 GUADALCANAL ST
SAN DIEGO, CA 92140
San Diego County (619) 524-1963
MR. GARY CHERRY JR. IDC
Military Health Care Provider (Independent Duty Corpsman)
35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MCRD
SAN DIEGO, CA 92140
San Diego County (619) 524-4045
SCOTT LA FALCE ATC
Specialist/Technologist (Athletic Trainer)
35000 GUADALCANAL ST
SAN DIEGO, CA 92140
San Diego County (619) 392-5425
MR. JAMES E COOK IDC
Military Health Care Provider (Independent Duty Corpsman)
35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MCRD
SAN DIEGO, CA 92140
San Diego County (619) 524-4102
LAURA J MAYENKNECHT NRP
Emergency Medical Technician, Paramedic
35000 GUADALCANAL ST
SAN DIEGO, CA 92140
San Diego County (619) 524-0833
XIN DU
Physician Assistant
35000 GUADALCANAL ST
SAN DIEGO, CA 92140
San Diego County (619) 524-4045
BRANCH MEDICAL CLINIC MCRD
Clinic/Center (Military/U.S. Coast Guard Outpatient)
35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MCRD
SAN DIEGO, CA 92140
San Diego County (619) 524-4102
DR. JACLYN MILLER AU.D.
Audiologist
35000 GUADALCANAL ST
SAN DIEGO, CA 92140
San Diego County (619) 524-1968

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 Reynaldo Reyes's NPI number?

The NPI number for Reynaldo Reyes is 1306800644. It was assigned to this individual provider in the NPPES registry on April 13, 2006.

Where is Reynaldo Reyes located?

Reynaldo Reyes practices at 35000 Guadalcanal St Branch Medical Clinic Marine Corps Recruit Depot, San Diego, CA 92140. The listed phone number is (619) 532-4056.

What is Reynaldo Reyes's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Is Reynaldo Reyes enrolled in Medicare?

Yes. Reynaldo Reyes is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Reynaldo Reyes was last updated on September 22, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.