Individual provider Active NPI

Beverly Ann Eisenhuth, D.O.

  • Obstetrics & Gynecology Physician
  • Broomall, PA
National Provider Identifier
1215224183
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OS017289 Issued in PA
Practice address
1991 Sproul Rd
Suite 200
Broomall, PA 19008-3512
Phone
(610) 325-1350
Fax
(610) 325-1357
NPI assigned
Jun 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OS017289 PA Primary

Addresses

Primary practice location

1991 Sproul Rd
Suite 200
Broomall, PA 19008-3512

Mailing address

1991 Sproul Rd
Suite 200
Broomall, PA 19008-3512
Phone (610) 325-1350

Other names 1

  • Beverly Ann Daub Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150609000305 PA Practitioner - Obstetrics/Gynecology 2264753888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Philadelphia College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

100 E Lancaster Ave
Wynewood, PA 19096-3450

1991 Sproul Rd
Broomall, PA 19008-3518

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

  • Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
  • Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
  • Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Obstetrics & Gynecology CurrentSince Jul 1, 2015 Accepting new patients

Locations

1991 Sproul Rd
Ste 200
Broomall, PA 19008
Phone (610) 325-1350

1991 Sproul Rd
#200
Broomall, PA 19008

1991 Sproul Rd
Ste 300
Broomall, PA 19008
Phone (610) 325-1373

1991 Sproul Rd
Ste 150
Broomall, PA 19008
Phone (610) 325-1350

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

1100 E Hector St
Ste 105
Conshohocken, PA 19428
Phone (610) 828-2608

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.

Hospital & facility affiliations 4

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": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1215224183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1991 SPROUL RD",
            "address_2": "SUITE 200",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083512",
            "telephone_number": "610-325-1350",
            "fax_number": "610-325-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 SPROUL RD",
            "address_2": "SUITE 200",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083512",
            "telephone_number": "610-325-1350",
            "fax_number": "610-325-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENHUTH",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OS017289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEVERLY",
            "last_name": "DAUB",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broomall, PA

Sources for this page

Verify at the official NPI Registry.