Active NPI
Joel Alvin Reiskin, M.D.
- Internal Medicine Physician
- Potomac, MD
National Provider Identifier
1720357536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- D0009764
- Practice address
- 11231 Potomac Crest Dr
Potomac, MD 20854-2769 - Phone
- (301) 299-3123
- NPI assigned
- Dec 22, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | D0009764 | MD | Primary |
Addresses
Primary practice location
11231 Potomac Crest Dr
Potomac, MD 20854-2769
Mailing address
11231 Potomac Crest Dr
Potomac, MD 20854-2769
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0009764 | MD | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Healthcare, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Adventist HealthCare Shady Grove Medical Center
- General Acute Care Hospital
- Rockville, MD
- NPI 1568468221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324512000000",
"number": "1720357536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11231 POTOMAC CREST DR",
"city": "POTOMAC",
"state": "MD",
"postal_code": "208542769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11231 POTOMAC CREST DR",
"city": "POTOMAC",
"state": "MD",
"postal_code": "208542769",
"telephone_number": "301-299-3123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REISKIN",
"first_name": "JOEL",
"middle_name": "ALVIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-22",
"last_updated": "2011-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MD",
"license": "D0009764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Potomac, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.