Leo Reisberg, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00265100 Issued in NJ

Practice address

11 Bishop PL
New Brunswick, NJ 08901-1178

Phone

(848) 932-7402

Fax

(732) 932-8255

NPI assigned

Aug 1, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Jersey Emergency Medical Associates LLC

  • Emergency Medicine Physician
  • Jersey City, NJ
  • NPI 1326211095
  NPD (past)
• Bimc Faculty Practice

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1538351572

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1437315181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SOMERSET ST APT 1202",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012081",
            "telephone_number": "908-752-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BISHOP PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011178",
            "telephone_number": "848-932-7402",
            "fax_number": "732-932-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISBERG",
        "first_name": "LEO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-01",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00265100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Reilly
• Anne Reinert
• Rickey Reinhardt, MD
• Ramon Reinoso Lizardo, MD
• Keith Reinsdorf, M.D.
• Jisha Reji, DO
• Aparna Repaka, M.D.
• Shiri Reuveni, CCC-SLP
• Elda B Reyes, PT
• Frances Rhoads, M.D.

• Physician Assistant in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.