Individual provider Active NPI

Igal Reizis, M.D.

  • Obstetrics & Gynecology Physician
  • Brooklyn, NY
National Provider Identifier
1750386264
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
141768 Issued in NY
Practice address
5925 15TH Ave
Brooklyn, NY 11219-5009
Phone
(718) 972-2700
Fax
(718) 972-2701
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 141768 NY Primary

Addresses

Primary practice location

5925 15TH Ave
Brooklyn, NY 11219-5009

Mailing address

5925 15TH Ave
Brooklyn, NY 11219-5009
Phone (718) 972-2700

Other identifiers 1

IdentifierTypeStateIssuer
00771444MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1750386264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 15TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112195009",
            "telephone_number": "718-972-2700",
            "fax_number": "718-972-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 15TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112195009",
            "telephone_number": "718-972-2700",
            "fax_number": "718-972-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIZIS",
        "first_name": "IGAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "141768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00771444",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.