Individual provider Active NPI

Steven Christopher Reschak, DO

  • Otolaryngology Physician
  • Grand Blanc, MI
National Provider Identifier
1356360614
Registry record updated Apr 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
51014325 Issued in MI
Practice address
3455 Regency Park Dr
Grand Blanc, MI 48439-2559
Phone
(810) 694-0600
Fax
(810) 694-0601
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 51014325 MI Primary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 5101014325 MI

Addresses

Primary practice location

3455 Regency Park Dr
Grand Blanc, MI 48439-2559

Mailing address

3455 Regency Park Dr
Grand Blanc, MI 48439-2559
Phone (810) 694-0600

Other identifiers 1

IdentifierTypeStateIssuer
4638591MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20041013000224 MI Practitioner - Otolaryngology 2163481573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear, Nose, Throat and Plastic Surgery Associates, P.C.Group PAC ID 7416031877, 6 clinicians

Practice addresses (Care Compare)

3455 Regency Park Dr
Grand Blanc, MI 48439-2559
Phone (810) 694-0600

Hospital & facility affiliations

  • Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197
  • McLaren Flint Hospital, Flint, MI, CCN 230141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51014325MIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose Throat and Plastic Surgery Associates PC Otolaryngology CurrentSince Aug 12, 2008 Accepting new patients

Locations

3455 Regency Park Dr
Grand Blanc, MI 48439
Phone (810) 694-0600

Interoperability endpoints

  • Direct secure messaging: sreschak1148922@direct.hfhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1356360614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 REGENCY PARK DR",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392559",
            "telephone_number": "810-694-0600",
            "fax_number": "810-694-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 REGENCY PARK DR",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392559",
            "telephone_number": "810-694-0600",
            "fax_number": "810-694-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESCHAK",
        "first_name": "STEVEN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "51014325",
            "primary": true
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MI",
            "license": "5101014325",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4638591",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.