| Mark Thomas Reis, MD | |
|
81 Highland Springs Ave, Suite 103, Beaumont, CA 92223-3170 | |
| (951) 845-0313 | |
| (360) 414-5758 |
| Full Name | Mark Thomas Reis |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 39 Years |
| Location | 81 Highland Springs Ave, Beaumont, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982709432 | NPI | - | NPPES |
| 000258 | Medicaid | OR | |
| 8467847 | Medicaid | WA | |
| FU515Z | Other | CA | MEDICARE |
| 8943021 | Other | WA | CRIME VICTIMS |
| 215163 | Other | WA | LABOR & IND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | G88836 (California) | Primary |
| 207X00000X | Orthopaedic Surgery | 00032312 (Washington) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Banner Lassen Medical Center | Susanville, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Banner Health | 9537078365 | 20 |
| Entity Name | San Bernardino Medical Orthopaedic Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336187475 PECOS PAC ID: 9335045228 Enrollment ID: O20040303001330 |
| Entity Name | Acute Care Surgery Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700069549 PECOS PAC ID: 7214006816 Enrollment ID: O20080522000355 |
| Entity Name | Sutter Valley Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669846986 PECOS PAC ID: 9830094515 Enrollment ID: O20090311000335 |
| Entity Name | Surgical Affiliates Of California |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932440781 PECOS PAC ID: 3375782667 Enrollment ID: O20130618000127 |
| Entity Name | Banner Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205267549 PECOS PAC ID: 9537078365 Enrollment ID: O20140604002057 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Thomas Reis, MD Po Box 10069, San Bernardino, CA 92423-0069 Ph: (909) 335-4188 | Mark Thomas Reis, MD 81 Highland Springs Ave, Suite 103, Beaumont, CA 92223-3170 Ph: (951) 845-0313 |