Individual provider Active NPI

Laura Colleen Reifsteck, PAC

  • Medical Physician Assistant
  • Washington, DC
National Provider Identifier
1336179423
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA200001625 Issued in DC
Practice address
2021 K St NW Ste 600
Washington, DC 20006-1051
Phone
(202) 888-8365
NPI assigned
Jul 4, 2006
Last updated
Jan 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X AMD203 HI
Medical Physician Assistant 363AM0700X PA200001625 DC Primary

Addresses

Primary practice location

2021 K St NW Ste 600
Washington, DC 20006-1051

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-2704

Other practice location 1

5255 Loughboro Rd NW
Washington, DC 20016-2633
Phone (202) 537-4122

Other identifiers 2

IdentifierTypeStateIssuer
54862001MedicaidHI
PA200001625OtherDCSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231109000267 DC Practitioner - Physician Assistant 3870583032 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AMD203HIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University CurrentSince Nov 1, 2023 Accepting new patients
Johns Hopkins University CurrentSince Nov 1, 2023 Accepting new patients
Capitol Breathe Free Sinus & Allergy Centers CurrentSince Jul 9, 2023 Accepting new patients
Medical Faculty Associates, Inc Past Accepting new patients
Hawaii Neurosurgery Group LLP PastSince Apr 1, 2004 Accepting new patients

Locations

2021 K St NW
Ste 600
Washington, DC 20006
Phone (202) 741-3387

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: lreifsteck1158170@direct.hopkinsmedicine.org

Organizations & group practices 6

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1336179423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 K ST NW STE 600",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061051",
            "telephone_number": "202-888-8365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5255 Loughboro Rd NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200162633",
            "country_code": "US",
            "telephone_number": "202-537-4122",
            "fax_number": "202-537-0158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REIFSTECK",
        "first_name": "LAURA",
        "middle_name": "COLLEEN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "HI",
            "license": "AMD203",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA200001625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54862001",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA200001625",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.