Provider Demographics
NPI:1164496220
Name:REYES, RUBEN (MD)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:REYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-6029
Mailing Address - Fax:
Practice Address - Street 1:2330 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-2005
Practice Address - Country:US
Practice Address - Phone:913-588-6029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01666207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
789683OtherMVP HEALTH CARE
7977717OtherAETNA US HEALTHCARE
92443OtherFALLON COMMUNITY HEALTH P
0408351OtherEVERCARE
042472266OtherUNITED HEALTHCARE
87425OtherHEALTHY START
J28914OtherBLUE SHIELD HMO BLUE
042472266OtherPRIVATE HEALTHCARE SYSTEM
4613180OtherCIGNA HEALTH PLAN
466559OtherTUFTS HEALTH PLAN
87425OtherCHILDRENS MEDICAL SECURIT
2103966OtherMEDICAID WELFARE
AA37371OtherHARVARD PILGRIM HEALTHCAR
J28914OtherBLUE CARE ELECT
042472266OtherONE HEALTH PLAN
MA2103966Medicaid
P00253383OtherRAILROAD MEDICARE
042472266OtherUNITED HEALTHCARE
2103966OtherMEDICAID WELFARE
A38519Medicare ID - Type UnspecifiedB