Active NPI
Allan M Eisenbaum, MD
- Ophthalmology Physician
- Lubbock, TX
National Provider Identifier
1144259656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 44326
- Practice address
- 3601 4TH St
Ste 2A100
Lubbock, TX 79430-7217 - Phone
- (806) 743-2020
- Fax
- (806) 743-1782
- NPI assigned
- Jun 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 22433 | KS | |
| Ophthalmology Physician | 207W00000X | 44326 | TX | Primary |
Addresses
Primary practice location
3601 4TH St
Ste 2A100
Lubbock, TX 79430-7217
Mailing address
PO Box 5865
Lubbock, TX 79408-5865
Phone (806) 743-2898
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13883 | Other | KS | PHS |
| 53746872 | Other | KS | MULTIPLAN |
| 100198520B | Medicaid | KS | |
| 650862 | Other | KS | BCBS |
| 119954 | Other | KS | COVENTRY |
| 196320901 | Medicaid | TX | |
| 205163 | Other | KS | HPK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22433 | KS | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384732800000",
"number": "1144259656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5865",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794085865",
"telephone_number": "806-743-2898",
"fax_number": "806-743-2787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 4TH ST",
"address_2": "STE 2A100",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794307217",
"telephone_number": "806-743-2020",
"fax_number": "806-743-1782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISENBAUM",
"first_name": "ALLAN",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-30",
"last_updated": "2013-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "KS",
"license": "22433",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TX",
"license": "44326",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS",
"identifier": "13883",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "53746872",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100198520B",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "650862",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "119954",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "196320901",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPK",
"identifier": "205163",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.