Individual provider Active NPI

Peter T Reissmann, M.D

  • Medical Oncology Physician
  • Bellingham, WA
National Provider Identifier
1407891641
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
MD60827333 Issued in WA
Practice address
3301 Squalicum Pkwy
Bellingham, WA 98225-1919
Phone
(360) 788-8222
Fax
(360) 788-7759
NPI assigned
Jun 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60827333 WA
Internal Medicine Physician 207R00000X 143046 AK
Hematology (Internal Medicine) Physician 207RH0000X MD60827333 WA
Hematology (Internal Medicine) Physician 207RH0000X 143046 AK
Hematology & Oncology Physician 207RH0003X G57545 CA
Medical Oncology Physician 207RX0202X 143046 AK
Medical Oncology Physician 207RX0202X MD60827333 WA Primary

Addresses

Primary practice location

3301 Squalicum Pkwy
Bellingham, WA 98225-1919

Mailing address

1115 SE 164TH Ave Dept 358
Vancouver, WA 98683-8004
Phone (360) 729-1462

Other identifiers 1

IdentifierTypeStateIssuer
00G575450MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20190219001815 WA Practitioner - Medical OncologyPractitioner - HematologyPractitioner - Internal Medicine 6800809328 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57545CAMDMarriage & Family Therapist
G57545CAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Current Accepting new patients

Locations

1117 Spring St
Friday Harbor, WA 98250
Phone (360) 378-1738

Interoperability endpoints

  • Direct secure messaging: preissmann401859@direct.peacehealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1407891641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "360-729-1462",
            "fax_number": "360-729-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 SQUALICUM PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251919",
            "telephone_number": "360-788-8222",
            "fax_number": "360-788-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISSMANN",
        "first_name": "PETER",
        "middle_name": "T",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60827333",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AK",
            "license": "143046",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "WA",
            "license": "MD60827333",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "AK",
            "license": "143046",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G57545",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "AK",
            "license": "143046",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "WA",
            "license": "MD60827333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G575450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.