Individual provider Active NPI

Joshua Eikenberg, M.D.

  • Dermatology Physician
  • Roanoke, VA
National Provider Identifier
1053708685
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101267144 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 981-7120
Fax
(540) 983-1133
NPI assigned
Apr 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 0101267144 VA Primary

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7120

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jeikenberg11327@direct.carilionclinic.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20221115001461 HI Practitioner - Dermatology 2567791056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete DermatologyGroup PAC ID 1759510316, 6 clinicians

Practice addresses (Care Compare)

100 Kahelu Ave
Suite 226
Mililani, HI 96789-3962
Phone (808) 621-1000

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1683
Skin biopsy363

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Dermatology Dermatology CurrentSince Jan 15, 2023 Accepting new patients
Paul S Takiguchi MD Inc Dermatology Past Accepting new patients

Locations

98-1079 Moanalua Rd
Ste 550
Aiea, HI 96701
Phone (808) 487-0083

1001 Kamokila Blvd
Ste 181
Kapolei, HI 96707
Phone (808) 375-7445

100 Kahelu Ave
Ste 226
Mililani, HI 96789
Phone (808) 594-8579

Networks

  • devoted network organization-c89d4c14-e90f-4cf7-83f9-456527a52335
  • HI PPO

Interoperability endpoints

  • Direct secure messaging: jeikenberg11327@direct.carilionclinic.org

Organizations & group practices 2

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": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1053708685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7120",
            "fax_number": "540-983-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-981-7120",
            "fax_number": "540-983-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIKENBERG",
        "first_name": "JOSHUA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-21",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101267144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeikenberg11327@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jeikenberg11327@direct.carilionclinic.org",
            "address_1": "1906 Belleview Ave SE",
            "city": "Roanoke",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240141838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.