Active NPI
Diane M. Reisinger, MD
- MOHS-Micrographic Surgery Physician
- Santa Fe, NM
National Provider Identifier
1003975699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- MOHS-Micrographic Surgery Physician
- License
- MD2011-0829
- Practice address
- 2019 Galisteo St Ste N9B
Santa Fe, NM 87505 - Phone
- (505) 980-8738
- Fax
- (505) 404-8423
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician | 207ND0101X | MD2011-0829 | NM | Primary |
Addresses
Primary practice location
2019 Galisteo St Ste N9B
Santa Fe, NM 87505
Mailing address
PO Box 604
Placitas, NM 87043-0604
Other practice location 1
5600 Eubank Blvd NE Ste 110
Albuquerque, NM 87111-1519
Phone (505) 880-1920
Other practice location 2
2019 Galisteo St Ste N9B
Santa Fe, NM 87505
Phone (505) 980-8738
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 0 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 0
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD2011-0829 | NM | MD | MOHS-Micrographic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology of Santa Fe PC | Current | Accepting new patients | |
| Skin in the Game, PLLC | Past | Accepting new patients |
Locations
2019 Galisteo St
Ste N9B
Santa Fe, NM 87505
Phone (505) 980-8738
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dermatology Physician
- Santa Fe, NM
- NPI 1043344476
-
- Dermatology Physician
- Gautier, MS
- NPI 1760043046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1003975699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 604",
"city": "PLACITAS",
"state": "NM",
"postal_code": "870430604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2019 GALISTEO ST STE N9B",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87505",
"telephone_number": "505-980-8738",
"fax_number": "505-404-8423"
}
],
"practiceLocations": [
{
"address_1": "5600 Eubank Blvd NE Ste 110",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871111519",
"country_code": "US",
"telephone_number": "505-880-1920",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2019 Galisteo St Ste N9B",
"address_purpose": "LOCATION",
"city": "Santa Fe",
"state": "NM",
"postal_code": "87505",
"country_code": "US",
"telephone_number": "505-980-8738",
"fax_number": "505-404-8423",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REISINGER",
"first_name": "DIANE",
"middle_name": "M.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "NM",
"license": "MD2011-0829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.