NPIMap

Individual provider Active NPI

Deborah Lynn Eisenmann, MD

  • Family Medicine Physician
  • Mt Pleasant, MI
National Provider Identifier
1235227950
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DE055682 Issued in MI
Practice address
2591 S Leaton Rd
Mt Pleasant, MI 48858
Phone
(989) 775-4603
Fax
(989) 775-4680
NPI assigned
Oct 10, 2006
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DE055682 MI Primary

Addresses

Primary practice location

2591 S Leaton Rd
Mt Pleasant, MI 48858

Mailing address

2591 S Leaton Rd
Mt Pleasant, MI 48858
Phone (989) 775-4603

Other identifiers 3

IdentifierTypeStateIssuer
2854523MedicaidMI
G05822OtherBCN GROUP
0370609OtherBCBS PPO PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060314000729 MI Practitioner - Family Practice 7315954484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oral Roberts University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saginaw Chippewa Indian TribeGroup PAC ID 8820068893, 7 clinicians

Practice addresses (Care Compare)

2591 S Leaton Rd
Mount Pleasant, MI 48858-8421
Phone (989) 775-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DE055682MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saginaw Chippewa Indian Tribe CurrentSince Mar 30, 1987 Accepting new patients
Saginaw Chippewa Indian Tribe CurrentSince Mar 30, 1987 Accepting new patients

Locations

2591 S Leaton Rd
Mt Pleasant, MI 48858
Phone (989) 775-4600

Interoperability endpoints

  • Direct secure messaging: deisenmann@sagchip.directbygreenway.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1235227950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2591 S LEATON RD",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-775-4603",
            "fax_number": "989-775-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2591 S LEATON RD",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-775-4603",
            "fax_number": "989-775-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENMANN",
        "first_name": "DEBORAH",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "DE055682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2854523",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GROUP",
            "identifier": "G05822",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PPO PIN",
            "identifier": "0370609",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.