Individual provider Active NPI

Christopher Eisenbeis, OD

  • Optometrist
  • Washington, MO
National Provider Identifier
1063289916
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2024035315 Issued in MO
Practice address
851 E 5TH St Ste 112
Washington, MO 63090-3128
Phone
(636) 239-8345
NPI assigned
Dec 11, 2023
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2972 MD
Optometrist 152W00000X 2024035315 MO Primary

Addresses

Primary practice location

851 E 5TH St Ste 112
Washington, MO 63090-3128

Mailing address

9241 Tea Rose LN
Saint Louis, MO 63126-2509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014000903 MO Practitioner - Optometry 2769914977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Ophthalmology LLCGroup PAC ID 1951544428, 17 clinicians
Mercy Health Services LLCGroup PAC ID 2264329168, 3 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 5006B
Saint Louis, MO 63141-8270
Phone (314) 251-5300

851 E 5TH St
Washington, MO 63090-3135
Phone (636) 239-8345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA2972MDMDOptometrist
2024035315MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Ophthalmology LLC CurrentSince Nov 4, 2024 Accepting new patients
Mercy Health Services, LLC Optometrist CurrentSince Sep 23, 2024 Accepting new patients
Mercy Health Services, LLC Optometrist CurrentSince Nov 4, 2024 Accepting new patients
Mercy Health Services, LLC Optometrist CurrentSince Nov 4, 2024 Accepting new patients

Locations

621 S New Ballas Rd
Ste 140A
Saint Louis, MO 63141
Phone (314) 251-5300

621 S New Ballas Rd
Ste 5006B
Saint Louis, MO 63141
Phone (314) 251-5300

851 E 5th St
Ste 112
Washington, MO 63090
Phone (636) 239-8345

901 Patients First Dr
Ste 2600
Washington, MO 63090
Phone (636) 231-3651

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1063289916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9241 TEA ROSE LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631262509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 E 5TH ST STE 112",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903128",
            "telephone_number": "636-239-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBEIS",
        "first_name": "CHRISTOPHER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-11",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2972",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2024035315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

Verify at the official NPI Registry.