Jackson Reiss

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

350 10TH Ave
San Diego, CA 92101-7496

Phone

(619) 764-5348

NPI assigned

Feb 8, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rekinected Physical Therapy IncGroup PAC ID 7810302023, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Rekinected Physical Therapy, Inc

  • Physical Therapist
  • Carlsbad, CA
  • NPI 1194312538
  Medicare reassignment Care Compare group NPD
• Fit Athletic Club San Diego LLC

  • General Practice Physician
  • San Diego, CA
  • NPI 1073047593
  NPD (past)

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1376307496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 HAINES ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921095316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 10TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017496",
            "telephone_number": "619-764-5348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISS",
        "first_name": "JACKSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Reischling
• Dominique Lindsen Reison, MA, APCC
• Alana Claire Reiss
• Belinda F Reiss
• David Mitchel Reiss, M.D.
• Joselyn Reiss
• Reagan Reissner
• Brian Reiswig
• Emily S Reiter
• Kathryn June Reiter

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.