Alejandro A Eisma, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

43119 Issued in WI

Practice address

1300 South Drive
Winnebago Mental Health Institute
Winnebago, WI 54985-0009

Phone

(920) 235-4910

Fax

(920) 236-2931

NPI assigned

Oct 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: alejandro.eisma.1@18748.direct.athenahealth.com

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.

• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Multi-Specialty Clinic/Center
  • Neenah, WI
  • NPI 1730126392
  NPD (past)
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1225026990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 S KOELLER ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026186",
            "telephone_number": "920-223-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SOUTH DRIVE",
            "address_2": "WINNEBAGO MENTAL HEALTH INSTITUTE",
            "city": "WINNEBAGO",
            "state": "WI",
            "postal_code": "549850009",
            "telephone_number": "920-235-4910",
            "fax_number": "920-236-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISMA",
        "first_name": "ALEJANDRO",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "43119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34115400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine N Carriere, APNP
• Jesse Elizabeth Childs, PA-C
• Cognitive Continuum Care
• Ann Patrice Decker, OTR
• Raul M Dejesus, M.D.
• Louis M Fulton, MD
• Carlo Gallo Gaanan, MD
• Susan Lisa Griswold, APNP
• Jeremiah Mobisa Gwaro, APNP
• Annette M Hart, PT

• Internal Medicine Physician in Winnebago, WI
• Providers in Winnebago, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.