Individual provider Active NPI

Marc Eiseman, M.D.

  • Anesthesiology Physician
  • Milwaukee, WI
National Provider Identifier
1124091855
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
41571 Issued in WI
Practice address
945 N 12TH St
Milwaukee, WI 53233-1305
Phone
(414) 219-2000
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 41571 WI Primary
Family Medicine Physician 207Q00000X 41571 WI

Addresses

Primary practice location

945 N 12TH St
Milwaukee, WI 53233-1305

Mailing address

3301 W Forest Home Ave Ste 300
Milwaukee, WI 53215-2843
Phone (414) 389-2233

Other identifiers 2

IdentifierTypeStateIssuer
88567290007OtherWIBC/BS
32588800MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address meiseman286146@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20070727000758 WI Practitioner - Anesthesiology 2769583277 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Northwestern University Feinberg Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

945 N 12TH St
Milwaukee, WI 53233-1305
Phone (414) 219-7300

Hospital & facility affiliations

  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41571WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 26, 2020 Accepting new patients
Aurora Medical Group, Inc. Family Medicine Current Accepting new patients
Watertown Physician Practices LLC Family Medicine Current Accepting new patients
Watertown Physician Practices LLC CurrentSince Jan 1, 2016 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Oct 26, 2020 Accepting new patients
The Medical College of Wisconsin, Inc. Anesthesiology CurrentSince Jul 1, 2011 Accepting new patients
Milwaukee Recovery Associates LLC Past Accepting new patients
Prohealth Medical Group Inc. Family Medicine PastSince Jun 1, 2003 Accepting new patients
Davis Medical Clinic, SC Past Accepting new patients

Locations

375 W River Woods Pkwy
Glendale, WI 53212
Phone (414) 326-1500

575 W River Woods Pkwy
Glendale, WI 53212
Phone (414) 961-6700

13133 N Port Washington Rd
Ste 116
Mequon, WI 53097
Phone (262) 243-3700

10911 N Port Washington Rd
Mequon, WI 53092
Phone (262) 241-2080

3301 W Forest Home Ave
Ste 300
Milwaukee, WI 53215

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

Bin 88350
Milwaukee, WI 53288
Phone (414) 805-3122

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

2323 N Lake Dr
Milwaukee, WI 53211
Phone (414) 291-1000

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

10000 W Innovation Dr
Ste 300
Wauwatosa, WI 53226

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9435/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1124091855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE STE 300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-389-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 N 12TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331305",
            "telephone_number": "414-219-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISEMAN",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "41571",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "41571",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "88567290007",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32588800",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "meiseman286146@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "945 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "945 N 12th St",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532331305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.