Timothy Martin Reisenauer, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1287 Issued in WA

Practice address

15418 Main St Unit 301
Mill Creek, WA 98012-9031

Phone

(425) 385-2362

NPI assigned

Jan 14, 2008

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

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Summit Consulting Group, Inc.

  • Clinical Psychologist
  • Mill Creek, WA
  • NPI 1568525251
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1407032063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15418 MAIN ST UNIT 301",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15418 MAIN ST UNIT 301",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129031",
            "telephone_number": "425-385-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISENAUER",
        "first_name": "TIMOTHY",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "1287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwendolyn Marie Reid, RN
• Ericka Katlin Reihl
• Kay Lowson Reimers, LICSW,
• Lauren Louise Reinhard, PT
• Rachel C Reinhardt, M.D.
• Natalie Maria Reyes, APRN
• Geoffrey W. Reynolds, RPH
• Theresia Annette Richardson, MA.ED., LMHCA
• Justin Rigoloso, ARNP
• Caroline Lea Rinke, PHD

• Psychologist in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.