Individual provider Active NPI

Jesse Reisner, DO

  • Rheumatology Physician
  • Quincy, MA
National Provider Identifier
1104322783
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
1014112 Issued in MA
Practice address
1495 Hancock St
Quincy, MA 02169-5229
Phone
(781) 878-5200
NPI assigned
Apr 3, 2018
Last updated
May 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 1014112 MA Primary

Addresses

Primary practice location

1495 Hancock St
Quincy, MA 02169-5229

Mailing address

1495 Hancock St
Quincy, MA 02169-5229
Phone (781) 878-5200

Other practice location 1

143 Longwater Dr
Norwell, MA 02061-1683
Phone (781) 878-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20230831000786 MA Practitioner - Rheumatology 4880093269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Arizona College of Osteopathic Medicine Mid Western University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Shore Medical Center, Inc.Group PAC ID 3678487444, 174 clinicians

Practice addresses (Care Compare)

1495 Hancock St
Quincy, MA 02169-5229
Phone (781) 878-5200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.58 of 100Reported as group
Quality
58.14
Promoting interoperability
74
Improvement activities
40
Cost
72.13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Medical Center, Inc. Rheumatology CurrentSince Aug 1, 2023 Accepting new patients

Locations

5 Tarkiln Rd
Kingston, MA 02364
Phone (781) 585-2200

141 Longwater Dr
Ste 201
Norwell, MA 02061
Phone (781) 261-7820

143 Longwater Dr
Norwell, MA 02061
Phone (781) 792-4136

1495 Hancock St
Quincy, MA 02169
Phone (617) 745-4100

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1104322783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 HANCOCK ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695229",
            "telephone_number": "781-878-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 HANCOCK ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695229",
            "telephone_number": "781-878-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "143 Longwater Dr",
            "address_purpose": "LOCATION",
            "city": "Norwell",
            "state": "MA",
            "postal_code": "020611683",
            "country_code": "US",
            "telephone_number": "781-878-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REISNER",
        "first_name": "JESSE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MA",
            "license": "1014112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.