Individual provider Active NPI

Michael Van Riesberg, M.D.

  • Otolaryngology Physician
  • Pensacola, FL
National Provider Identifier
1407831191
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME 75687 Issued in FL
Practice address
2411 Executive Plaza Rd
Pensacola, FL 32504-8269
Phone
(850) 476-0700
Fax
(850) 476-4300
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME 75687 FL Primary

Addresses

Primary practice location

2411 Executive Plaza Rd
Pensacola, FL 32504-8269

Mailing address

2411 Executive Plaza Rd
Pensacola, FL 32504-8269
Phone (850) 476-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20051012000814 FL Practitioner - Otolaryngology 5496770059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Indiana University School of Medicine, 1985
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

4900 N Davis Hwy
Pensacola, FL 32503-2344
Phone (850) 476-0700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 75687FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael V Riesberg MD Otolaryngology & Performing Arts Medicine Otolaryngology CurrentSince Jan 12, 2009 Accepting new patients
Aaron B Stein MD PLLC Past Accepting new patients

Locations

4900 N Davis Hwy
Pensacola, FL 32503
Phone (850) 476-0700

Organizations & group practices 2

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 3

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1407831191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 EXECUTIVE PLAZA RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048269",
            "telephone_number": "850-476-0700",
            "fax_number": "850-476-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 EXECUTIVE PLAZA RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048269",
            "telephone_number": "850-476-0700",
            "fax_number": "850-476-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESBERG",
        "first_name": "MICHAEL",
        "middle_name": "VAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME 75687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.