Individual provider Active NPI

Michael Eiswerth, DO

  • Gastroenterology Physician
  • Virginia Beach, VA
National Provider Identifier
1154882009
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0102209916 Issued in VA
Practice address
1717 Will O Wisp Dr Ste 200
Virginia Beach, VA 23454-3102
Phone
(757) 481-4817
NPI assigned
Mar 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0102209916 VA Primary

Addresses

Primary practice location

1717 Will O Wisp Dr Ste 200
Virginia Beach, VA 23454-3102

Mailing address

1717 Will O Wisp Dr Ste 200
Virginia Beach, VA 23454-3102
Phone (757) 481-4817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20260429000973 VA Practitioner - GastroenterologyPractitioner - Internal Medicine 1355751124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10770 Columbia Pike
Suite 400
Silver Spring, MD 20901-4441

1322 N 34TH St
Richmond, VA 23223-6837

National Provider Directory

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

Organizations & group practices 1

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1154882009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 WILL O WISP DR STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543102",
            "telephone_number": "757-481-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 WILL O WISP DR STE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234543102",
            "telephone_number": "757-481-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISWERTH",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0102209916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.