Elliot Michael Reisman, M.D.

Primary specialty

Pediatric Urology PhysicianTaxonomy code 2088P0231X

License

ME57771 Issued in FL

Practice address

4712 N Armenia Ave
Suite 200
Tampa, FL 33603-2611

Phone

(813) 874-7400

Fax

(813) 877-1397

NPI assigned

Sep 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Childrens Urology Group PL

  • Pediatric Urology Physician
  • Tampa, FL
  • NPI 1194836239
  NPD (past)

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1114913423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 N ARMENIA AVE",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032611",
            "telephone_number": "813-874-7400",
            "fax_number": "813-877-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 N ARMENIA AVE",
            "address_2": "SUITE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032611",
            "telephone_number": "813-874-7400",
            "fax_number": "813-877-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISMAN",
        "first_name": "ELLIOT",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "FL",
            "license": "ME57771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063642800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diego C Reino, MD
• Carly Reinoehl, BA
• Tyler Robert Reinoso, MD
• Michael Reintgen, MD
• Megan Reisch, AT
• Alexander I Reiss, M.D.
• Martina A Reiss, MD
• Grace Anne-Margaret Reitz
• Anjana Reji, DO
• Denise Diane Rejonis, CCC/SLP

• Pediatric Urology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Pediatric Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.