Individual provider Active NPI

Randy Earl Eisenhut, MD

  • Pediatrics Physician
  • Dayton, OH
National Provider Identifier
1174580948
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35058652E Issued in OH
Practice address
6551 Centerville Business Pkwy Ste 110
Dayton, OH 45459-2696
Phone
(937) 291-6850
Fax
(947) 291-6896
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35058652E OH Primary

Addresses

Primary practice location

6551 Centerville Business Pkwy Ste 110
Dayton, OH 45459-2696

Mailing address

PO Box 933432
Cleveland, OH 44193-0039
Phone (937) 641-3555

Other practice location 1

200 Rockridge Rd Ste 110
Englewood, OH 45322-2751
Phone (937) 836-9921

Other practice location 2

1152 W 3rd St Ste 102
Dayton, OH 45402-6848
Phone (937) 268-3483

Other practice location 3

3333 W Tech Rd Ste 120
Miamisburg, OH 45342-0956
Phone (937) 748-6116

Other practice location 4

8501 Old Troy Pike Ste 120
Huber Heights, OH 45424-1061
Phone (937) 237-4945

Other practice location 5

1425 N Fairfield Rd Ste 120
Beavercreek, OH 45432-2674
Phone (937) 320-3888

Other identifiers 1

IdentifierTypeStateIssuer
0817638MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160829000339 OH Practitioner - Pediatric Medicine 4284847021 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Childrens Specialty Physicians IncGroup PAC ID 5496916124, 93 clinicians

Practice addresses (Care Compare)

6551 Centerville Business Pkwy
Centerville, OH 45459-2695
Phone (937) 291-6850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35058652EOHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Children'S Specialty Physicians, Inc. Pediatrics CurrentSince Jan 14, 2024 Accepting new patients
Premier Integrated Medical Assoc LTD CurrentSince Jul 12, 2016 Accepting new patients
Premier Integrated Medical Assoc LTD Pediatrics CurrentSince Jul 12, 2016 Accepting new patients
Premier Integrated Medical Assoc LTD Pediatrics Current Accepting new patients
Dayton Children'S Specialty Physicians, Inc. Pediatrics CurrentSince Oct 2, 2023 Accepting new patients

Locations

1425 N Fairfield Rd
Ste 120
Beavercreek, OH 45432
Phone (937) 320-3888

25 Merchant St
Ste 220
Cincinnati, OH 45246

1152 W 3rd St
Dayton, OH 45402
Phone (937) 268-3483

1152 W 3rd St
Ste 102
Dayton, OH 45402
Phone (937) 268-3483

6551 Centerville Business Pkwy
Ste 100
Dayton, OH 45459
Phone (937) 291-6830

6551 Centerville Business Pkwy
Dayton, OH 45459
Phone (937) 291-6850

6551 Centerville Business Pkwy
Ste 110
Dayton, OH 45459
Phone (937) 291-6850

200 Rockridge Rd
Ste 110
Englewood, OH 45322
Phone (937) 836-9921

8501 Old Troy Pike
Ste 120
Huber Heights, OH 45424
Phone (937) 237-4945

1900 Composite Dr
Kettering, OH 45420
Phone (937) 293-8419

967 Bellefontaine Ave
Lima, OH 45804
Phone (419) 224-1330

3333 W Tech Rd
Ste 120
Miamisburg, OH 45342
Phone (937) 748-6116

Organizations & group practices 5

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1174580948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 933432",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930039",
            "telephone_number": "937-641-3555",
            "fax_number": "937-641-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 CENTERVILLE BUSINESS PKWY STE 110",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454592696",
            "telephone_number": "937-291-6850",
            "fax_number": "947-291-6896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Rockridge Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "453222751",
            "country_code": "US",
            "telephone_number": "937-836-9921",
            "fax_number": "937-836-1298",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1152 W 3rd St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454026848",
            "country_code": "US",
            "telephone_number": "937-268-3483",
            "fax_number": "937-268-1884",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420956",
            "country_code": "US",
            "telephone_number": "937-748-6116",
            "fax_number": "937-291-6956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8501 Old Troy Pike Ste 120",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241061",
            "country_code": "US",
            "telephone_number": "937-237-4945",
            "fax_number": "937-237-4925",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 N Fairfield Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454322674",
            "country_code": "US",
            "telephone_number": "937-320-3888",
            "fax_number": "937-320-3848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EISENHUT",
        "first_name": "RANDY",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35058652E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0817638",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.