Kendra Suzanne Reisner, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD451051 Issued in PA

Practice address

1907 Lebanon Church Rd
Suite 201
West Mifflin, PA 15122

Phone

(412) 653-8500

Fax

(412) 653-8515

NPI assigned

Apr 14, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kreisner211950@direct.hopkinsmedicine.org

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.

• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1578598868

  Pediatrics

  Medicare reassignment NPD
• Johns Hopkins Community Physicians

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1356161806
  NPD
• Johns Hopkins Community Physicians, Inc

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1770518003
  NPD
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1053637173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 FRANKLIN SQUARE DR STE 2110",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364902",
            "telephone_number": "410-933-5412",
            "fax_number": "410-933-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 LEBANON CHURCH RD",
            "address_2": "SUITE 201",
            "city": "WEST MIFFLIN",
            "state": "PA",
            "postal_code": "15122",
            "telephone_number": "412-653-8500",
            "fax_number": "412-653-8515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1907 Lebanon Church Rd",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "West Mifflin",
            "state": "PA",
            "postal_code": "151222432",
            "country_code": "US",
            "telephone_number": "412-653-8500",
            "fax_number": "412-653-8515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REISNER",
        "first_name": "KENDRA",
        "middle_name": "SUZANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-14",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD451051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primary Care Pharmacy Services Inc
• Prism Health Services
• Heather L Putney, LMFT
• Q Pharma Inc
• Victoria Marie Quimpo Moretti, MD
• Vicente Edgardo Reyes Sr., M.D.
• Marina Rezk, D.O.
• Robert D Richey
• Tara Kern Rose, O.D.
• Nicole Rae Rosenfeld, RPH, PHARMD

• Pediatrics Physician in West Mifflin, PA
• Providers in West Mifflin, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.