Individual provider Active NPI

Dwight O. Eichelberger, M.D.

  • Family Medicine Physician
  • Elizabethtown, PA
National Provider Identifier
1336128719
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD424587 Issued in PA
Practice address
418 Cloverleaf Rd
Elizabethtown, PA 17022-9320
Phone
(717) 653-1467
Fax
(717) 653-1001
NPI assigned
Jan 12, 2006
Last updated
Sep 24, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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 MD424587 PA Primary

Addresses

Primary practice location

418 Cloverleaf Rd
Elizabethtown, PA 17022-9320

Mailing address

418 Cloverleaf Rd
Elizabethtown, PA 17022-9320
Phone (717) 653-1467

Other identifiers 9

IdentifierTypeStateIssuer
50053533OtherPACAPITAL BLUE CROSS
3628851OtherPAAETNA HMO
93183 S101OtherPAGEISINGER HEALTH PLAN
1010970330002MedicaidPA
F56379OtherPAHEALTH ASSURANCE
805335OtherPAHIGHMARK BLUE SHIELD
P00267525OtherPARAILROAD MEDICARE
P006466OtherPAGATEWAY HEALTH PLAN
5397699OtherPAAETNA NON-HMO

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
I20040827000830 PA Practitioner - Family Practice 1658346291 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD424587PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster General Medical Group CurrentSince Nov 1, 2005 Accepting new patients
Lancaster General Medical Group Family Medicine CurrentSince Nov 1, 2005 Accepting new patients
Lancaster General Medical Group Current Accepting new patients

Locations

418 Cloverleaf Rd
Elizabethtown, PA 17022
Phone (717) 653-1467

3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644

1001 Cornerstone Dr
#B
Mount Joy, PA 17552
Phone (717) 653-2929

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1336128719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 CLOVERLEAF RD",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170229320",
            "telephone_number": "717-653-1467",
            "fax_number": "717-653-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 CLOVERLEAF RD",
            "city": "ELIZABETHTOWN",
            "state": "PA",
            "postal_code": "170229320",
            "telephone_number": "717-653-1467",
            "fax_number": "717-653-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHELBERGER",
        "first_name": "DWIGHT",
        "middle_name": "O.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD424587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50053533",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3628851",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER HEALTH PLAN",
            "identifier": "93183 S101",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010970330002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ASSURANCE",
            "identifier": "F56379",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "805335",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00267525",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY HEALTH PLAN",
            "identifier": "P006466",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO",
            "identifier": "5397699",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, PA

Sources for this page

Verify at the official NPI Registry.