Organization Active NPI

Keith J Reisler MD, PA

  • Specialist
  • Plano, TX
National Provider Identifier
1093839870
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G8956 Issued in TX
Legal business name
KEITH J REISLER MD, PA
Practice address
3108 Midway Rd
Suite 205
Plano, TX 75093-6383
Phone
(972) 985-9684
Fax
(972) 985-0590
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Keith J Reisler, MDNPI 1972502417
Title
Owner
Phone
(972) 985-9684

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G8956 TX Primary

Addresses

Primary practice location

3108 Midway Rd
Suite 205
Plano, TX 75093-6383

Mailing address

3108 Midway Rd
Suite 205
Plano, TX 75093-6383
Phone (972) 985-9684

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070330000510 TX Part B Supplier - Clinic/Group Practice 0749384725 Receives reassigned benefits from 1 practitioner
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093839870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 MIDWAY RD",
            "address_2": "SUITE 205",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936383",
            "telephone_number": "972-985-9684",
            "fax_number": "972-985-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 MIDWAY RD",
            "address_2": "SUITE 205",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936383",
            "telephone_number": "972-985-9684",
            "fax_number": "972-985-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH J REISLER MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REISLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-985-9684",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "G8956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.