Eric Andrew Eisen, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD61047604 Issued in WA

Practice address

1231 116TH Ave NE Ste 930
Bellevue, WA 98004-3804

Phone

(425) 688-1916

Fax

(425) 688-1901

NPI assigned

May 3, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Otolaryngology

Education

University of Oklahoma College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eric.eisen.p61@direct.proliance.nextgenshare.com

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.

• Proliance Surgeons Inc P S

  dba Proliance Surgeons Orthopedic Specialists of Seattle

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment Care Compare group NPD
• Proliance Surgeons Inc P S

  dba Proliance Orthopedic Associates

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463
  NPD
• Proliance Surgeons Inc., P.S.

  dba Proliance Surgical Specialists of Edmonds

  • Surgery Physician
  • Edmonds, WA
  • NPI 1073540894
  NPD
• Proliance Surgeons, Inc., P.S.

  dba Proliance Eastside Surgical Specialists

  • Surgery Physician
  • Bellevue, WA
  • NPI 1578801718

  Otolaryngology

  NPD
• Proliance Surgeons, Inc., P.S.

  dba Proliance South Seattle Otolaryngology

  • Otolaryngology Physician
  • Burien, WA
  • NPI 1114108784
  NPD (past)

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

{
    "created_epoch": "1430611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1104203793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 116TH AVE NE STE 930",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043804",
            "telephone_number": "425-688-1916",
            "fax_number": "425-688-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 116TH AVE NE STE 930",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043804",
            "telephone_number": "425-688-1916",
            "fax_number": "425-688-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISEN",
        "first_name": "ERIC",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-03",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "WA",
            "license": "MD61047604",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD61047604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2160928",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "427413",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Kathleen Eichenberger, LMP
• Eric Eidens, M.A.
• Eiji Minami
• Sharon Eiler, LMFT
• Larry William Einspahr, MD
• Andrea Eisner, M.D.
• Victoria Jordana Eisner, LCSW
• Bill Ray Ekemo, PH.D.
• Barbara Diane El Naby, AAC
• El Roi Ensy Psychiatry PLLC

• Otolaryngology Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Otolaryngology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.