Active NPI
Vanna A Reisman, CNM
- Obstetrics & Gynecology Nurse Practitioner
- East Syracuse, NY
National Provider Identifier
1801878640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- F360502-1
- Practice address
- 824 Franklin Park Dr.
East Syracuse, NY 13057 - Phone
- (315) 432-1048
- Fax
- (315) 432-9219
- NPI assigned
- Nov 17, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | F0005381 | NY | |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | F360502-1 | NY | Primary |
Addresses
Primary practice location
824 Franklin Park Dr.
East Syracuse, NY 13057
Mailing address
824 Franklin Park Dr.
East Syracuse, NY 13057
Phone (315) 432-1048
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02185537 | Medicaid | NY |
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
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F0005381 | NY | MD | Midwife |
| F360502-1 | NY | MD | Obstetrics & Gynecology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Antosh MD PC | Past | Accepting new patients | |
| David M. Girardi, OD, LLC | Past | Accepting new patients | |
| Cathy J. Berry, M.D., P.C. | Obstetrics & Gynecology | Past | Accepting new patients |
Interoperability endpoints
- vanna.reisman@howardmweinsteinmdpc.chartmakerdirect.com
Organizations & group practices 3
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.
-
- Obstetrics & Gynecology Physician
- Syracuse, NY
- NPI 1992784573
-
- Optometrist
- East Syracuse, NY
- NPI 1972916096
-
- Legal Medicine
- East Syracuse, NY
- NPI 1184716888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583971200000",
"number": "1801878640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "824 FRANKLIN PARK DR.",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "13057",
"telephone_number": "315-432-1048",
"fax_number": "315-432-9219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "824 FRANKLIN PARK DR.",
"city": "EAST SYRACUSE",
"state": "NY",
"postal_code": "13057",
"telephone_number": "315-432-1048",
"fax_number": "315-432-9219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REISMAN",
"first_name": "VANNA",
"middle_name": "A",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-17",
"last_updated": "2020-03-12",
"certification_date": "2020-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "NY",
"license": "F0005381",
"primary": false
},
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "NY",
"license": "F360502-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02185537",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in East Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.