Ehrentraud Johanna Eichelbaum, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

U7674 Issued in TX

Practice address

21685 Kingsland Blvd
Katy, TX 77450-2512

Phone

(346) 594-2104

Fax

(346) 594-2103

NPI assigned

Jan 30, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

General Practice

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

C3 Wellness LLCGroup PAC ID 1355605502, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• C3 Wellness, LLC

  • Multi-Specialty Clinic/Center
  • Kissimmee, FL
  • NPI 1811490287

  General Practice

  Medicare reassignment Care Compare group NPD
• Lake Nona Medical Services

  • General Practice Physician
  • Orlando, FL
  • NPI 1285296798
  Medicare reassignment NPD
• Lowell F. Clark MD PA

  • Internal Medicine Physician
  • Bushnell, FL
  • NPI 1629278882
  Medicare reassignment
• Pro-Elite Management Services Corp

  • General Practice Physician
  • Katy, TX
  • NPI 1922814250
  NPD
• JM Medical Group, LLC

  • Specialist
  • Rio Piedras, PR
  • NPI 1487350021
  NPD (past)

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1255518486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8514 SUN CORAL DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774337529",
            "telephone_number": "941-779-4869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21685 KINGSLAND BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774502512",
            "telephone_number": "346-594-2104",
            "fax_number": "346-594-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHELBAUM",
        "first_name": "EHRENTRAUD",
        "middle_name": "JOHANNA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "U7674",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18573",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "U7674",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME140028",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Egwuatu
• Mohammed Ehimeakhe
• Esther C Ehirim
• Jeanette Ehlers, AUD
• Parvaneh Ehsanzadeh Cheemeh, M.D., MPH
• Ej&a Healthcare Services LLC
• Irene Ejianreh
• Lilley A Ekangaki, PTA
• Cassie Ekdahl
• Olufunmilayo O. Ekundare, PMHNP

• General Practice Physician in Katy, TX
• Providers in Katy, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.