Provider Demographics
NPI:1235183435
Name:BISKER, JEFFREY S (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:BISKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 PARK EAST DR
Mailing Address - Street 2:SUITE 450
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4305
Mailing Address - Country:US
Mailing Address - Phone:855-292-1401
Mailing Address - Fax:866-396-8340
Practice Address - Street 1:3700 PARK EAST DR
Practice Address - Street 2:SUITE 450
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4305
Practice Address - Country:US
Practice Address - Phone:855-292-1401
Practice Address - Fax:866-396-8340
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00317222085N0904X, 2085R0202X
NY131808-12085R0202X
PA4192292085R0202X
KY219752085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
186465OtherAMERIGROUP
FLME31722OtherWORKERS' COMP
696678OtherCIGNA
KY7100200600Medicaid
FLP00402367OtherRR MEDICARE FRL
OH0773177Medicaid
DC097830500Medicaid
PA1028868150001Medicaid
MI1235183435Medicaid
O55404473OtherCHAMPUS
FL267034800Medicaid
FL29167OtherBCBS
FL29167WMedicare PIN
PA070817YA6CMedicare PIN
FL267034800Medicaid
FL29167OtherBCBS
FLP00402367OtherRR MEDICARE FRL
696678OtherCIGNA
C69302Medicare UPIN
KY7100200600Medicaid
FLP00396311Medicare PIN
FLP00077729Medicare PIN
FL29167XMedicare PIN