Active NPI
Brian James Reisenauer
- Psychologist
- Scottsdale, AZ
National Provider Identifier
1609691278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY-005858
- Practice address
- 8501 E Princess Dr Ste 100
Scottsdale, AZ 85255-5481 - Phone
- (480) 299-1965
- NPI assigned
- Nov 19, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY-005858 | AZ | Primary |
Addresses
Primary practice location
8501 E Princess Dr Ste 100
Scottsdale, AZ 85255-5481
Mailing address
22118 N Las Positas Dr
Sun City West, AZ 85375-6826
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 14, 2024 through Nov 14, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-005858 | AZ | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shier Private Practice | Current | Accepting new patients |
Locations
8501 E Princess Dr
Ste 100
Scottsdale, AZ 85255
Phone (480) 299-1965
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.
-
- Psychiatry Physician
- Scottsdale, AZ
- NPI 1598483018
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1731974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732665600000",
"number": "1609691278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22118 N LAS POSITAS DR",
"city": "SUN CITY WEST",
"state": "AZ",
"postal_code": "853756826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8501 E PRINCESS DR STE 100",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852555481",
"telephone_number": "480-299-1965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REISENAUER",
"first_name": "BRIAN",
"middle_name": "JAMES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-11-19",
"last_updated": "2024-11-27",
"certification_date": "2024-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "PSY-005858",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.