Randall Rissman, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

142652 Issued in NY

Practice address

404 Zena Road
Woodstock, NY 12498-2626

Phone

(845) 679-5271

Fax

(845) 679-3237

NPI assigned

Sep 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1376645911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 ZENA ROAD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124982626",
            "telephone_number": "845-679-5271",
            "fax_number": "845-679-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 ZENA ROAD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124982626",
            "telephone_number": "845-679-5271",
            "fax_number": "845-679-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSMAN",
        "first_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-03",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "142652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00728056",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Redmond
• Brooke Reynolds, MHC-LP
• Margaretmary Cliggett Reynolds, LMHC
• Cinnamon Rinzler, P.A.
• Barbara Rissman, MSW
• Heather Roberts, PT
• Elfe K Robinson, PH. D.
• Elizabeth Anne Rogers
• Maria J Rojas Tenorio, MHC-LP
• Stephanie Lorraine Rooker, LMSW

• Family Medicine Physician in Woodstock, NY
• Providers in Woodstock, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.