Individual provider Active NPI

Diane M. Reisinger, MD

  • MOHS-Micrographic Surgery Physician
  • Santa Fe, NM
National Provider Identifier
1003975699
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
MD2011-0829 Issued in NM
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

Updated by the provider on Apr 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2011-0829NMMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology of Santa Fe PC CurrentSince Oct 15, 2016 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.

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.

Verify at the official NPI Registry.