Bruce K Reisman, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

G59056 Issued in CA

Practice address

3907 Waring Rd Ste 1a
Oceanside, CA 92056-4454

Phone

(760) 724-8749

Fax

(760) 724-2604

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: breisman81508@scrippshlth.medalliesdirect.net

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.

• ENT Associates Medical Group

  • Otolaryngology Physician
  • Oceanside, CA
  • NPI 1720098148
  Medicare reassignment NPD Authorized official
• Aristamd

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1235671660
  Medicare reassignment NPD
• Northbay Healthcare Group

  • General Acute Care Hospital
  • Fairfield, CA
  • NPI 1821147786
  Medicare reassignment NPD
• Northbay Healthcare Group

  • Multi-Specialty Clinic/Center
  • Vacaville, CA
  • NPI 1760534713
  NPD
• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1699785014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3907 WARING RD STE 1A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564454",
            "telephone_number": "760-724-8749",
            "fax_number": "760-724-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3907 WARING RD STE 1A",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564454",
            "telephone_number": "760-724-8749",
            "fax_number": "760-724-2604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "361 High St",
            "address_purpose": "LOCATION",
            "city": "Somersworth",
            "state": "NH",
            "postal_code": "038781407",
            "country_code": "US",
            "telephone_number": "603-692-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REISMAN",
        "first_name": "BRUCE",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NH",
            "license": "LT4368",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G59056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G590560",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G590560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paula Louise Regan, MS
• Regency Eye Care, Inc.
• Dixie Reid
• Frances Maire Reid
• Regine Reimers, D.O.
• Shantae Renee
• Renew Behavioral Health
• Crista Jude Renteria, LVN
• Monica Renteria
• Kevin Reusch, PA-C

• Otolaryngology Physician in Oceanside, CA
• Providers in Oceanside, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.