Individual provider Active NPI

Michael Issac Reinganum, MD

  • Emergency Medicine Physician
  • Bowling Green, KY
National Provider Identifier
1376288688
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
60468 Issued in KY
Practice address
250 Park St
Bowling Green, KY 42101-1760
Phone
(270) 745-1000
NPI assigned
May 2, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 60468 KY Primary

Addresses

Primary practice location

250 Park St
Bowling Green, KY 42101-1760

Mailing address

605 Pine CT
Bowling Green, KY 42103-7927
Phone (615) 569-4852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20250807000072 KY Practitioner - Emergency Medicine 7315316734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

250 Park St
Bowling Green, KY 42101-1795
Phone (270) 745-1000

Hospital & facility affiliations

  • The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60468KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Single Specialty CurrentSince Jul 1, 2025 Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

1501 S Dixie St
Park, KY 42749
Phone (270) 745-1255

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

Interoperability endpoints

  • Direct secure messaging: michael.reinganum@mmhs.medicity.net

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 1

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": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1376288688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 PINE CT",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037927",
            "telephone_number": "615-569-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011760",
            "telephone_number": "270-745-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINGANUM",
        "first_name": "MICHAEL",
        "middle_name": "ISSAC",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-02",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "60468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.