ENT Associates Medical Group

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

ENT ASSOCIATES MEDICAL GROUP

Practice address

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

Phone

(760) 724-8749

NPI assigned

Aug 8, 2006

Organization subpart

No

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

Authorized official

Name

Bruce K Reisman, MDNPI 1699785014

Title

Associate

Phone

(760) 724-8749

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Interoperability endpoints

• Direct secure messaging: richardliu@entaca.allscriptsdirect.net
• Direct secure messaging: robertjacobs@entaca.allscriptsdirect.net
• Direct secure messaging: sarahcarroll@entaca.allscriptsdirect.net

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarah Rossmiller Carroll, M.D.

  • Otolaryngology Physician
  • Glendale, CA
  • NPI 1962608281
  Medicare reassignment Care Compare group NPD
• Robert Jacobs, MD

  • Otolaryngology Physician
  • Oceanside, CA
  • NPI 1023028446
  Medicare reassignment Care Compare group NPD
• Richard Ming-Cheng Liu, MD

  • Otolaryngology Physician
  • La Mesa, CA
  • NPI 1548286453
  Medicare reassignment Care Compare group NPD
• Bruce K Reisman, MD

  • Otolaryngology Physician
  • Oceanside, CA
  • NPI 1699785014
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720098148",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENT ASSOCIATES MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REISMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "ASSOCIATE",
        "authorized_official_telephone_number": "760-724-8749",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0044880",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ27998Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Engel
• Kana England
• Tracey A Engleton
• Kimberley N Engols, DDS
• Allen Chase Ennis, IDC
• Envoycare Inc
• Eol, Inc.
• Steven Lloyd Epner, MD
• Mallery Saleem Eppler, AUD
• Eric Rypins MD Facs Apc

• 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.