Individual provider Active NPI

Keith James Reisler, M.D.

  • Obstetrics & Gynecology Physician
  • Plano, TX
National Provider Identifier
1972502417
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G8956 Issued in TX
Practice address
3108 Midway Rd
Suite 205
Plano, TX 75093-6383
Phone
(972) 985-9684
Fax
(972) 985-0590
NPI assigned
Jul 18, 2005
Reactivated
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 G8956 TX Primary

Addresses

Primary practice location

3108 Midway Rd
Suite 205
Plano, TX 75093-6383

Mailing address

3108 Midway Rd
Suite 205
Plano, TX 75093-6383
Phone (972) 985-9684

Other identifiers 1

IdentifierTypeStateIssuer
G8956OtherTXMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070330000441 TX Practitioner - Obstetrics/Gynecology 8426152497 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Keith J Reisler MD, PA Obstetrics & Gynecology CurrentSince Jan 5, 1989 Accepting new patients
Pinnacle Anesthesia Consultants, PLLC Past Accepting new patients

Locations

3108 Midway Rd
Ste 204
Plano, TX 75093
Phone (214) 501-1333

3108 Midway Rd
Ste 205
Plano, TX 75093
Phone (972) 985-9684

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972502417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 MIDWAY RD",
            "address_2": "SUITE 205",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936383",
            "telephone_number": "972-985-9684",
            "fax_number": "972-985-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 MIDWAY RD",
            "address_2": "SUITE 205",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936383",
            "telephone_number": "972-985-9684",
            "fax_number": "972-985-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISLER",
        "first_name": "KEITH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-27",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "G8956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G8956",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.