NPIMap

Individual provider Active NPI

Peter D Reisner, MD

  • Family Medicine Physician
  • Barron, WI
National Provider Identifier
1982664017
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44822 Issued in WI
Practice address
1222 E Woodland Ave
Barron, WI 54812-1765
Phone
(715) 838-5222
NPI assigned
Mar 24, 2006
Last updated
Feb 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44822 WI Primary

Addresses

Primary practice location

1222 E Woodland Ave
Barron, WI 54812-1765

Mailing address

200 1St St SW
Rochester, MN 55905-1510
Phone (715) 838-5222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address preisner24285@ehrdirect.mayoclinicmsg.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040820000069 WI Practitioner - Family Practice 8123092707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1222 E Woodland Ave
Barron, WI 54812-1765
Phone (715) 537-3166

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44822WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Current Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. Past Accepting new patients

Locations

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1222 E Woodland Ave
Barron, WI 54812
Phone (715) 537-3166

220 Douglas St
Chetek, WI 54728
Phone (715) 924-4811

725 Knapp St
Chetek, WI 54728
Phone (715) 924-4891

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

2409 Stout Rd
Menomonie, WI 54751
Phone (715) 231-3937

200 Memorial Dr
Mondovi, WI 54755
Phone (715) 926-4858

Interoperability endpoints

  • Direct secure messaging: preisner24285@ehrdirect.mayoclinicmsg.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Meadowbrook at ChetekChetek, WI, CCN 525672 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 1, 2019
Jan 1, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1982664017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559051510",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 E WOODLAND AVE",
            "city": "BARRON",
            "state": "WI",
            "postal_code": "548121765",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISNER",
        "first_name": "PETER",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "44822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "preisner24285@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1222 E Woodland Ave",
            "city": "Barron",
            "state": "WI",
            "country_code": "US",
            "postal_code": "548121765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Barron, WI

Sources for this page

Verify at the official NPI Registry.