Stephen Bernard Reznicek, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MC-0557 Issued in ID

Practice address

1006 North H Street
Aberdeen, WA 98520

Phone

(360) 537-6470

Fax

(360) 537-6475

NPI assigned

May 11, 2006

Last updated

Aug 27, 2020By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sreznicek468073@ahs.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stephen B Reznicek M.D. P.C.

  • Urology Physician
  • Cadillac, MI
  • NPI 1982891180
  NPD Authorized official
• Brian R Drabik D.O. P.C.

  • Urology Physician
  • Cadillac, MI
  • NPI 1992992192
  NPD

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1801846704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1787",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "98520",
            "telephone_number": "231-779-2565",
            "fax_number": "231-775-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 NORTH H STREET",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "98520",
            "telephone_number": "360-537-6470",
            "fax_number": "360-537-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZNICEK",
        "first_name": "STEPHEN",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "ID",
            "license": "MC-0557",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "062640",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "297815510",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rehabvisions
• Kaitlyn Elizabeth Reid, CBT
• Renal Care Group Northwest, Inc. (Fresenius Kidney Care Gray's Harbor)
• Gabriel C Renville
• Resilient Therapeutics & Massage PLLC
• Michaela Sarai Richardson, RN
• Crystal Dawn Sanchez Richey
• Patricia Rider
• Julie Mae Rifenberg, RN
• Tammy Lea Roberson

• Urology Physician in Aberdeen, WA
• Providers in Aberdeen, WA by specialty
• Urology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.