Individual provider Active NPI

Frederick H Reeser, M.D.

  • Ophthalmology Physician
  • Milwaukee, WI
National Provider Identifier
1093710741
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
18419 Issued in WI
Practice address
2600 N Mayfair Rd
Ste 901
Milwaukee, WI 53226-1307
Phone
(414) 774-3484
Fax
(414) 778-3445
NPI assigned
Jun 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 18419 WI Primary

Addresses

Primary practice location

2600 N Mayfair Rd
Ste 901
Milwaukee, WI 53226-1307

Mailing address

212 Chinaberry LN
Ste 901
Kiawah Island, SC 29455-5854
Phone (414) 333-5300

Other identifiers 3

IdentifierTypeStateIssuer
82052OtherWICHILDRENS COMM HEALTH
30939600MedicaidWI
560162200MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18419WIMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1119052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1093710741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 CHINABERRY LN",
            "address_2": "STE 901",
            "city": "KIAWAH ISLAND",
            "state": "SC",
            "postal_code": "294555854",
            "telephone_number": "414-333-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "STE 901",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261307",
            "telephone_number": "414-774-3484",
            "fax_number": "414-778-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESER",
        "first_name": "FREDERICK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-18",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "18419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS COMM HEALTH",
            "identifier": "82052",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30939600",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "560162200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.