Individual provider Active NPI

Alexander M Eisen, DO

  • Pediatrics Physician
  • Charlottesville, VA
National Provider Identifier
1366490682
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0102201876 Issued in VA
Practice address
1204 W Main St
Charlottesville, VA 22903-2824
Phone
(434) 924-5321
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0102201876 VA Primary
Pediatrics Physician 208000000X 5800150 OH
Pediatrics Physician 208000000X DO.1311 AL
General Practice Physician 208D00000X 0102201876 VA

Addresses

Primary practice location

1204 W Main St
Charlottesville, VA 22903-2824

Mailing address

PO Box 749112
Atlanta, GA 30374-9112
Phone (434) 295-1000

Other practice location 1

105 E Watts St
Enterprise, AL 36330-2511
Phone (334) 393-5437

Other practice location 2

1215 Lee St
Charlottesville, VA 22908-0816
Phone (434) 924-5321

Other identifiers 2

IdentifierTypeStateIssuer
0102201876MedicaidVA
146239MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180913002158 DC Practitioner - Pediatric Medicine 6204186133 Reassigns benefits to 1 organization
I20181002002018 VA Practitioner - Pediatric Medicine 6204186133 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO.1311ALMDPediatrics Physician
5800150OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Aug 15, 2018 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Aug 15, 2018 Accepting new patients
Emergency Medicine Associates P.a., P.C. Pediatrics CurrentSince Aug 15, 2018 Accepting new patients
University of Virginia Physicians Group CurrentSince Mar 1, 2026 Accepting new patients

Locations

20010 Century Blvd
Ste 200
Germantown, MD 20874

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

1204 W Main St
Charlottesville, VA 22903
Phone (434) 924-0123

1215 Lee St
Charlottesvle, VA 22908
Phone (434) 924-0211

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

1850 Town Center Pkwy
Reston, VA 20190
Phone (703) 478-0922

Interoperability endpoints

  • Direct secure messaging: aeisen583503@direct.healthsystem.virginia.edu
  • Direct secure messaging: alexander.eisen.p13@direct.warrentonpeds.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1366490682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112",
            "telephone_number": "434-295-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W MAIN ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032824",
            "telephone_number": "434-924-5321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 E Watts St",
            "address_purpose": "LOCATION",
            "city": "Enterprise",
            "state": "AL",
            "postal_code": "363302511",
            "country_code": "US",
            "telephone_number": "334-393-5437",
            "fax_number": "334-393-4185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-5321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EISEN",
        "first_name": "ALEXANDER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102201876",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "5800150",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "DO.1311",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102201876",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0102201876",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146239",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.