Individual provider Active NPI

Brian M Varisco, MD

  • Pediatric Critical Care Medicine Physician
  • Little Rock, AR
National Provider Identifier
1063562924
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
E-16817 Issued in AR
Practice address
1 Childrens Way # 512-1
Little Rock, AR 72202-3500
Phone
(501) 364-5262
Fax
(501) 364-3418
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X E-16817 AR Primary
Pediatrics Physician 208000000X E-16817 AR
Pediatric Critical Care Medicine Physician 2080P0203X 35-095132 OH

Addresses

Primary practice location

1 Childrens Way # 512-1
Little Rock, AR 72202-3500

Mailing address

1 Childrens Way # 653
Little Rock, AR 72202-3500
Phone (501) 364-1100

Other practice location 1

3333 Burnet Ave.
Critical Care Medicine ML 2005
Cincinnati, OH 45229-3039
Phone (513) 636-4259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20231106002880 AR Practitioner - Pediatric Medicine 9638171788 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Medical College of Georgia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Childrens Professional Services Organization LLCGroup PAC ID 4688183148, 180 clinicians

Practice addresses (Care Compare)

1 Childrens Way
Little Rock, AR 72202-3500
Phone (501) 364-2526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-095132OHMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Pediatrics CurrentSince Oct 24, 2023 Accepting new patients
Arkansas Childrens Hospital Pediatrics CurrentSince Oct 24, 2023 Accepting new patients
Arkansas Childrens Professional Services Organization LLC Pediatrics CurrentSince Jul 1, 2025 Accepting new patients
Arkansas Children's Hospital CurrentSince Oct 24, 2023 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Oct 24, 2023 Accepting new patients

Locations

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

1 Childrens Way
#5121
Little Rock, AR 72202
Phone (501) 364-5262

1 Childrens Way
Ste 653
Little Rock, AR 72202

Organizations & group practices 5

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1063562924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-1",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-5262",
            "fax_number": "501-364-3418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Burnet Ave.",
            "address_2": "Critical Care Medicine ML 2005",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293039",
            "country_code": "US",
            "telephone_number": "513-636-4259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARISCO",
        "first_name": "BRIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "AR",
            "license": "E-16817",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-16817",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "OH",
            "license": "35-095132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.