Eileen Elisabeth Van Diest, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

M7978 Issued in TX

Practice address

179 Enterprise Pkwy Ste 102
Boerne, TX 78006-8634

Phone

(830) 219-4162

Fax

(830) 310-7974

NPI assigned

Apr 22, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Eileen Elisabeth Fuller Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: evandiest@abileneendo.gwaydirect.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.

• Privia Medical Group West Texas, PLLC

  • Pathology Specialist/Technologist
  • Abilene, TX
  • NPI 1760482665
  NPD (past)

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1356515217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32685 US HIGHWAY 281 N STE 181",
            "city": "BULVERDE",
            "state": "TX",
            "postal_code": "781633271",
            "telephone_number": "830-219-4162",
            "fax_number": "830-310-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 ENTERPRISE PKWY STE 102",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068634",
            "telephone_number": "830-219-4162",
            "fax_number": "830-310-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DIEST",
        "first_name": "EILEEN",
        "middle_name": "ELISABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M7978",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "M7978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EILEEN",
            "last_name": "FULLER",
            "middle_name": "ELISABETH",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• US Renal Care Boerne LLC
• Uvalde County Hospital Authority
• Linda Valadez, LVN
• Validus Health, PA
• Bonnie Y Valles, LMSW 109421
• Christine Teresa Van Ramshorst, M.D.
• Ellen S Vandelden, MD
• Katherine Maryann Vandyke, D.C.
• Joe Everett Vandzura, RBT
• Julie Crosby Vargas, PTA

• All providers in Boerne, TX
• Endocrinology, Diabetes & Metabolism Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.