Individual provider Active NPI

Brian Jeffrey Eichenberg, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Murrieta, CA
National Provider Identifier
1033323118
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
A055426 Issued in CA
Practice address
24687 Monroe Ave
Murrieta, CA 92562-9591
Phone
(951) 506-1040
Fax
(951) 506-1044
NPI assigned
May 9, 2007
Last updated
Mar 12, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X A055426 CA Primary

Addresses

Primary practice location

24687 Monroe Ave
Murrieta, CA 92562-9591

Mailing address

24687 Monroe Ave
Murrieta, CA 92562-9591
Phone (951) 506-1040

Other identifiers 1

IdentifierTypeStateIssuer
00A554260MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040813000913 CA Practitioner - Plastic and Reconstructive Surgery 0345213807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Georgetown University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brian J. Eichenberg, M.D., a Professional CorporationGroup PAC ID 1456400647, 3 clinicians

Practice addresses (Care Compare)

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-4000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A055426CAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brian J. Eichenberg, M.D., a Professional Corporation CurrentSince Jul 3, 2001 Accepting new patients
Renuance Cosmetic Surgery Center PastSince Dec 15, 2024 Accepting new patients

Locations

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

24687 Monroe Ave
Murrieta, CA 92562
Phone (951) 309-7794

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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 1

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1033323118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24687 MONROE AVE",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629591",
            "telephone_number": "951-506-1040",
            "fax_number": "951-506-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24687 MONROE AVE",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629591",
            "telephone_number": "951-506-1040",
            "fax_number": "951-506-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHENBERG",
        "first_name": "BRIAN",
        "middle_name": "JEFFREY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A055426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A554260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.