Individual provider Active NPI

Jeffrey Louis Eisman, DC

  • Orthopedic Chiropractor
  • Detroit, MI
National Provider Identifier
1609900802
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
JE004022 Issued in MI
Practice address
17401 Greenfield
Detroit, MI 48235
Phone
(313) 837-3300
Fax
(313) 837-5550
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Chiropractor 111NX0800X JE004022 MI Primary
Orthopedic Chiropractor 111NX0800X CH3403 FL

Addresses

Primary practice location

17401 Greenfield
Detroit, MI 48235

Mailing address

17401 Greenfield
Detroit, MI 48235
Phone (313) 837-3300

Other identifiers 2

IdentifierTypeStateIssuer
95OH222000OtherMIBCBS
1348177MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100622000859 MI Practitioner - Chiropractic 3678604469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17401 Greenfield Rd
Detroit, MI 48235-3700
Phone (313) 837-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH3403FLMDOrthopedic Chiropractor
JE004022MIMDOrthopedic Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Eisman Clinic PC Orthopedic CurrentSince Mar 27, 1990 Accepting new patients

Locations

17401 Greenfield Rd
Detroit, MI 48235
Phone (313) 837-3300

Organizations & group practices 1

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1609900802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17401 GREENFIELD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-837-3300",
            "fax_number": "313-837-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17401 GREENFIELD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-837-3300",
            "fax_number": "313-837-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISMAN",
        "first_name": "JEFFREY",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "MI",
            "license": "JE004022",
            "primary": true
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "FL",
            "license": "CH3403",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "95OH222000",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1348177",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.