Individual provider Active NPI

Bradley Scott Eisemann, MD

  • Plastic Surgery Physician
  • Houston, TX
National Provider Identifier
1376802769
Registry record updated Feb 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
BP10043205 Issued in TX
Practice address
6354 Vanderbilt St
Houston, TX 77005-3416
Phone
(713) 858-5010
NPI assigned
May 7, 2012
Last updated
Feb 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X BP10043205 TX Primary
Plastic and Reconstructive Surgery Physician 2086S0122X R4216 TX

Addresses

Primary practice location

6354 Vanderbilt St
Houston, TX 77005-3416

Mailing address

6354 Vanderbilt St
Houston, TX 77005-3416
Phone (713) 858-5010

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190522000847 TX Practitioner - Plastic and Reconstructive Surgery 2860735404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Texas Medical School at Houston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael L Eisemann MD PA FacsGroup PAC ID 3375772254, 2 clinicians

Practice addresses (Care Compare)

6550 Fannin St
Suite 2119
Houston, TX 77030-2721
Phone (713) 790-1771

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy14
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10043205TXMDPlastic Surgery Physician
R4216TXMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael L. Eisemann, M.D.,P.a.,F.a.C.S. CurrentSince May 1, 2019 Accepting new patients
Fannin Day Surgery Center, LLC PastSince May 1, 2019 Accepting new patients

Locations

6550 Fannin St
Ste 2119
Houston, TX 77030
Phone (713) 790-1771

Interoperability endpoints

  • Direct secure messaging: beisemann237037@directhoustonmethodist.org

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 1

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": "1336348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1376802769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6354 VANDERBILT ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770053416",
            "telephone_number": "713-858-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6354 VANDERBILT ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770053416",
            "telephone_number": "713-858-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISEMANN",
        "first_name": "BRADLEY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "BP10043205",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "R4216",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.