Individual provider Active NPI

Thomas M Reinsvold, MD

  • Cardiovascular Disease Physician
  • McAlester, OK
National Provider Identifier
1154367332
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
20011 Issued in OK
Practice address
4 E Clark Bass Blvd
Suite 204
McAlester, OK 74501-4269
Phone
(918) 422-6071
Fax
(918) 421-6077
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 109396 MO
Cardiovascular Disease Physician 207RC0000X P4999 TX
Cardiovascular Disease Physician 207RC0000X 20011 OK Primary

Addresses

Primary practice location

4 E Clark Bass Blvd
Suite 204
McAlester, OK 74501-4269

Mailing address

114 Westfield Loop
Lufkin, TX 75904-7212
Phone (417) 437-7683

Other identifiers 5

IdentifierTypeStateIssuer
100214510AMedicaidOK
11496OtherMOANTHEM
100187310AMedicaidKS
208175406MedicaidMO
060035200OtherRR MEDICARE

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
I20100823000846 AR Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 8820060650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Un of California, Irvine, College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Physician Services LLCGroup PAC ID 4981698032, 49 clinicians

Practice addresses (Care Compare)

2205 W Main St
Cardiology Assoc of North Central Arkansas
Russellville, AR 72801-2759
Phone (479) 968-4311

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20011OKMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Physician Services LLC CurrentSince Sep 9, 2017 Accepting new patients
St Marys Physician Services, LLC CurrentSince Sep 9, 2017 Accepting new patients
St Marys Physician Services, LLC Past Accepting new patients
Northwest Benton County Physician Services LLC Past Accepting new patients

Locations

2205 W Main St
Russellville, AR 72801
Phone (479) 890-2654

101 Skyline Dr
Russellville, AR 72801
Phone (479) 968-2345

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1154367332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 WESTFIELD LOOP",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759047212",
            "telephone_number": "417-437-7683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 E CLARK BASS BLVD",
            "address_2": "SUITE 204",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745014269",
            "telephone_number": "918-422-6071",
            "fax_number": "918-421-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINSVOLD",
        "first_name": "THOMAS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "109396",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "P4999",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "20011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100214510A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "11496",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100187310A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208175406",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060035200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.