Daniel Mark Riesenberg, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

23718 Issued in AZ

Practice address

30037 N Whipsaw Rd
101
Peoria, AZ 85383-5195

Phone

(623) 238-8890

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, OR2 enrollments

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 2

Specialty

Urology

Education

University of Miami, LM Miller School of Medicine, 1971

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

AsanteGroup PAC ID 0547177321, 141 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Medicare reassignment Care Compare group NPD
• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917

  Family Medicine

  Medicare reassignment NPD
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Medicare reassignment NPD
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Medicare reassignment NPD
• Kingman Healthcare, Inc

  • Community/Retail Pharmacy
  • Kingman, AZ
  • NPI 1992286298
  NPD
• Asante

  • Specialty Pharmacy
  • Medford, OR
  • NPI 1699426684
  NPD
• Sky Lakes Medical Center Inc

  • Community/Retail Pharmacy
  • Klamath Falls, OR
  • NPI 1003654625
  NPD
• Kingman Healthcare, Inc

  • Specialist
  • Kingman, AZ
  • NPI 1689897787

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1356317416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-263-4722",
            "fax_number": "928-263-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30037 N WHIPSAW RD",
            "address_2": "101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853835195",
            "telephone_number": "623-238-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESENBERG",
        "first_name": "DANIEL",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TX",
            "license": "K4210",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AZ",
            "license": "23718",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NV",
            "license": "12281",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G31678",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ridges at Peoria, LLC
• Ridges at Peoria, LLC
• Ridges at Peoria, LLC
• Emily Riefenhauser
• Jennifer Gayle Ries-Clark, FNPC
• Austin J Rigby, DMD
• Megan Rigby, DNP
• Michelle Rigg
• Brandon Joseph Riley, PHARM.D., R.PH.
• Lanora Riley

• Urology Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Urology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.