Individual provider Active NPI

Andrew S Reisman, MD

  • Sports Medicine (Family Medicine) Physician
  • Wilmington, DE
National Provider Identifier
1841295912
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
C1-0005577 Issued in DE
Practice address
3505 Silverside Rd
Ste 100
Wilmington, DE 19810-4904
Phone
(302) 477-0900
Fax
(302) 477-0902
NPI assigned
Jun 16, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X C1-0005577 DE Primary

Addresses

Primary practice location

3505 Silverside Rd
Ste 100
Wilmington, DE 19810-4904

Mailing address

3505 Silverside Rd
Ste 100
Wilmington, DE 19810-4904
Phone (302) 477-0900

Other identifiers 8

IdentifierTypeStateIssuer
2144021OtherDEOPTIMUM CHOICE
4721OtherDEMID-ATLANTIC
0670506000OtherDEINDEPENDENCE BC/PC
0001044101MedicaidDE
0670506000OtherDEAMERIHEALTH/KEYSTONE
7911229OtherDEAETNA
2144021OtherDEALLIANCE
2144021OtherDEMAMSI

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

State licenses

LicenseStateTypeSpecialty
C1-0005577DEMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Casscells Orthopaedics and Sports Medicine, PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1841295912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 SILVERSIDE RD",
            "address_2": "STE 100",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104904",
            "telephone_number": "302-477-0900",
            "fax_number": "302-477-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 SILVERSIDE RD",
            "address_2": "STE 100",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104904",
            "telephone_number": "302-477-0900",
            "fax_number": "302-477-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISMAN",
        "first_name": "ANDREW",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "DE",
            "license": "C1-0005577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "2144021",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MID-ATLANTIC",
            "identifier": "4721",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BC/PC",
            "identifier": "0670506000",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001044101",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/KEYSTONE",
            "identifier": "0670506000",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7911229",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE",
            "identifier": "2144021",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2144021",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.