Individual provider Active NPI

Michael Eck Reischach, PT

  • Physical Therapist
  • Kenai, AK
National Provider Identifier
1306973557
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
823 Issued in AK
Practice address
150 N Willow St Ste 15
Kenai, AK 99611-9109
Phone
(907) 283-2765
Fax
(907) 283-2765
NPI assigned
Feb 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 823 AK Primary

Addresses

Primary practice location

150 N Willow St Ste 15
Kenai, AK 99611-9109

Mailing address

48584 Debra Cir
Kenai, AK 99611-9436
Phone (907) 776-5784

Other identifiers 1

IdentifierTypeStateIssuer
PT5626MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
823AKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kenai Kids Therapy Inc Physical Therapist Past Accepting new patients
Occupational Rehabilitative Services Inc Past Accepting new patients
Kenai Kids Therapy, Inc Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306973557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48584 DEBRA CIR",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996119436",
            "telephone_number": "907-776-5784",
            "fax_number": "907-776-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N WILLOW ST STE 15",
            "city": "KENAI",
            "state": "AK",
            "postal_code": "996119109",
            "telephone_number": "907-283-2765",
            "fax_number": "907-283-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISCHACH",
        "first_name": "MICHAEL",
        "middle_name": "ECK",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT5626",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenai, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.