Sol Reisin, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A39697 Issued in CA

Practice address

1550 North Imperial Avenue
Suite 1
El Centro, CA 92243-4242

Phone

(760) 353-4710

Fax

(760) 545-0244

NPI assigned

May 3, 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 6

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

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.

• Imperial Valley Family Care Medical Group Apc

  • General Practice Physician
  • Imperial, CA
  • NPI 1275581894
  Medicare reassignment NPD
• Imperial Valley Family Care Medical Group, Apc

  • Cardiac Rehabilitation Registered Nurse
  • Imperial, CA
  • NPI 1750112587
  NPD

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1700844222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 WEST ATEN ROAD",
            "address_2": "SUITE 2",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922519805",
            "telephone_number": "760-355-7730",
            "fax_number": "760-355-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 NORTH IMPERIAL AVENUE",
            "address_2": "SUITE 1",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434242",
            "telephone_number": "760-353-4710",
            "fax_number": "760-545-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISIN",
        "first_name": "SOL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A39697",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A39697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ZZZ#",
            "identifier": "ZZZ47484Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDI-CAL #",
            "identifier": "GR0066310",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A396970",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PIN#",
            "identifier": "110111657",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "W13536",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "WA39697B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ray Mun Loo MD Medical Corporation
• Saqib Razzaque, M.D
• Readypills Pharmacy LLC
• Stephanie Real
• Tina Reina
• Reliance Imperial Pharmacy LLC
• Reliance Imperial Pharmacy LLC
• Jessica Rendon
• Respiratory Therapy Technologies
• Retina Institute of California Medical Group, a California Medical Par

• Nephrology Physician in El Centro, CA
• Providers in El Centro, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.