Individual provider Active NPI

Marc Alan Reiskind, MD

  • Physical Medicine & Rehabilitation Physician
  • Clearwater, FL
National Provider Identifier
1306822614
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME63914 Issued in FL
Practice address
4400 140TH Ave N
Suite 110
Clearwater, FL 33762-3863
Phone
(727) 327-2600
Fax
(727) 327-2644
NPI assigned
Dec 19, 2005
Last updated
Jul 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME63914 FL Primary

Addresses

Primary practice location

4400 140TH Ave N
Suite 110
Clearwater, FL 33762-3863

Mailing address

PO Box 100267
Atlanta, GA 30384-0267
Phone (727) 327-2600

Other identifiers 1

IdentifierTypeStateIssuer
004873000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090210000775 FL Practitioner - Physical Medicine and Rehabilitation 8527123496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Medical College of Georgia School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinellas Physiatry Associates PAGroup PAC ID 3678678968, 3 clinicians

Practice addresses (Care Compare)

4400 140TH Ave N
Suite 110
Clearwater, FL 33762-3863
Phone (727) 327-2600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pinellas Physiatry Associates PA Physical Medicine & Rehabilitation CurrentSince May 1, 2008 Accepting new patients

Locations

4400 140th Ave N
Ste 110
Clearwater, FL 33762
Phone (727) 327-2600

666 6th St S
Ste 101
St Petersburg, FL 33701
Phone (727) 893-6714

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CACCAA

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 3

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1306822614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100267",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840267",
            "telephone_number": "727-327-2600",
            "fax_number": "727-327-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 140TH AVE N",
            "address_2": "SUITE 110",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337623863",
            "telephone_number": "727-327-2600",
            "fax_number": "727-327-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISKIND",
        "first_name": "MARC",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME63914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004873000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.