Individual provider Active NPI

Richard H. Eisenman, M.D.

  • Gastroenterology Physician
  • Conway, SC
National Provider Identifier
1053472175
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
14836 Issued in SC
Practice address
2376 Cypress Circle
Suite 203
Conway, SC 29526-8994
Phone
(843) 347-6038
Fax
(843) 347-9808
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 14836 SC Primary

Addresses

Primary practice location

2376 Cypress Circle
Suite 203
Conway, SC 29526-8994

Mailing address

PO Box 2180
Conway, SC 29528-2180
Phone (843) 347-6038

Other identifiers 2

IdentifierTypeStateIssuer
GP4505MedicaidSC
7844OtherSCMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20080421000256 SC Practitioner - Gastroenterology 4385722131

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
52.78 of 100Reported as group
Quality
55.48
Improvement activities
0
Cost
74.21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Hospital, Inc. Current Accepting new patients

Locations

808 Farrar Dr
Conway, SC 29526
Phone (843) 234-8700

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

2376 Cypress Cir
Ste 100
Conway, SC 29526
Phone (843) 234-6888

2376 Cypress Cir
Ste 203
Conway, SC 29526
Phone (843) 347-4600

394 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-8050

Organizations & group practices 1

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1053472175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2180",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295282180",
            "telephone_number": "843-347-6038",
            "fax_number": "843-234-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 CYPRESS CIRCLE",
            "address_2": "SUITE 203",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268994",
            "telephone_number": "843-347-6038",
            "fax_number": "843-347-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENMAN",
        "first_name": "RICHARD",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "SC",
            "license": "14836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4505",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "7844",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.