Individual provider Active NPI

Lisa Renee Reznick, M.D.

  • Orthopaedic Hand Surgery Physician
  • Carrollton, TX
National Provider Identifier
1629054531
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
K0169 Issued in TX
Practice address
4100 Fairway Dr
Suite 120
Carrollton, TX 75010-6525
Phone
(972) 395-9000
Fax
(972) 395-9002
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X K0169 TX
Orthopaedic Hand Surgery Physician 207XS0106X K0169 TX Primary

Addresses

Primary practice location

4100 Fairway Dr
Suite 120
Carrollton, TX 75010-6525

Mailing address

4100 Fairway Dr
Suite 120
Carrollton, TX 75010-6525
Phone (972) 395-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20051208000842 TX Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 0345261012 Practice locations: Carrollton, TX

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Hand Surgery
Education
University of Michigan Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4100 Fairway Dr
Carrollton, TX 75010-6526
Phone (972) 395-9000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K0169TXMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1629054531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 FAIRWAY DR",
            "address_2": "SUITE 120",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106525",
            "telephone_number": "972-395-9000",
            "fax_number": "972-395-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 FAIRWAY DR",
            "address_2": "SUITE 120",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106525",
            "telephone_number": "972-395-9000",
            "fax_number": "972-395-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNICK",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "K0169",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "TX",
            "license": "K0169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

Verify at the official NPI Registry.