CALEB MAUTI REID (DNP, MSN, PMHNP-BC.) – Psychiatric/Mental Health Nurse Practitioner, NPI 1053759217
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
Provider Addresses for CALEB MAUTI REID (DNP, MSN, PMHNP-BC.)
702 W HAMILTON PL
SUITE 7
SAN PEDRO, CA 907316372
Phone: (310) 935-7969
Type: Mailing
350 E COMMERCIAL RD
112
SAN BERNARDINO, CA 924085212
Phone: (480) 999-8200
Fax: (480) 800-2212
Type: Mailing
350 E COMMERCIAL RD STE 112
SAN BERNARDINO, CA 924083763
Phone: (909) 913-0600
Fax: (480) 800-2200
Type: Location
703 Walnut St
Boulder, CO 803025032
Phone: (480) 999-8200
Fax: (480) 800-2212
Type: Location
412 E Southern Ave
Tempe, AZ 852825212
Phone: (480) 797-4600
Fax: (480) 800-2212
Type: Location
410 E Southern Ave
Tempe, AZ 852825212
Phone: (480) 797-4600
Fax: (480) 800-2212
Type: Location
15150 W Park Pl
2nd floor -Suite 2031
Goodyear, AZ 85395
Phone: (480) 999-8200
Type: Location
1718 E SPEEDWAY BLVD # 4042
TUCSON, AZ 857194515
Phone: (651) 800-5991
Type: Mailing
2295 S VINEYARD AVE
ROOM 230
ONTARIO, CA 91761
Phone: (651) 800-5991
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-02-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 7 Medicare enrollment records; no due dates published yet.
Enrollment records
7
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230411002788 | I | Nurse Practitioner | AZ | TBD |
| I20231204001557 | I | Nurse Practitioner | CA | TBD |
| I20241125003296 | I | Nurse Practitioner | CO | TBD |
| I20250304003455 | I | Nurse Practitioner | OR | TBD |
| I20250312002420 | I | Nurse Practitioner | TX | TBD |
| I20250326000633 | I | Nurse Practitioner | WA | TBD |
| I20260219001471 | I | Nurse Practitioner | AK | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 90731)
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