Individual provider Active NPI

Reginald E. Ishman, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Warsaw, NY
National Provider Identifier
1710980016
Registry record updated May 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
162261 Issued in NY
Practice address
2469 State Route 19 N
Warsaw, NY 14569-9336
Phone
(585) 786-2288
Fax
(585) 786-3699
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 162261 NY Primary

Addresses

Primary practice location

2469 State Route 19 N
Warsaw, NY 14569-9336

Mailing address

2469 State Route 19 N
Warsaw, NY 14569-9336
Phone (585) 786-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100222000005 NY Practitioner - Ophthalmology 0446263131 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ues Optical, Inc PastSince Oct 14, 2014 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495152000000",
    "number": "1710980016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2469 STATE ROUTE 19 N",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145699336",
            "telephone_number": "585-786-2288",
            "fax_number": "585-786-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2469 STATE ROUTE 19 N",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145699336",
            "telephone_number": "585-786-2288",
            "fax_number": "585-786-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHMAN",
        "first_name": "REGINALD",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2017-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "162261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, NY

Sources for this page

Verify at the official NPI Registry.