Individual provider Active NPI

Bernard Eagleton, MD

  • Anesthesiology Physician
  • Jackson, MI
National Provider Identifier
1649211426
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
12795 Issued in LA
Practice address
255 W Michigan Ave
Jackson, MI 49201-2218
Phone
(517) 787-6440
Fax
(517) 787-4146
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 12795 LA Primary

Addresses

Primary practice location

255 W Michigan Ave
Jackson, MI 49201-2218

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, IL2 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
I20031201000702 LA Practitioner - Anesthesiology 3274438460 Reassigns benefits to 6 organizations
I20171227003036 IL Practitioner - Anesthesiology 3274438460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Southern Illinois University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Anesthesia CorporationGroup PAC ID 0446152862, 281 clinicians

Practice addresses (Care Compare)

4700 S I 10 Service Rd W
Tulane Lakeside Hospital
Metairie, LA 70001-1210
Phone (504) 613-0711

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12795LAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Mar 1, 2019 Accepting new patients
Dpi of Louisiana LLC Anesthesiology CurrentSince Jan 1, 2025 Accepting new patients
Midwest Anesthesia Providers S.C Anesthesiology CurrentSince Jan 1, 2018 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Mar 1, 2019 Accepting new patients
Diversified Professionals, Inc. Anesthesiology CurrentSince Oct 10, 2011 Accepting new patients
Childrens Hospital Anesthesia Corporation Anesthesiology CurrentSince Sep 1, 2023 Accepting new patients
The Capital City Anesthesia Group, LLC Anesthesiology CurrentSince May 7, 2004 Accepting new patients
Zephyr Anesthesia, LLC Anesthesiology CurrentSince Apr 1, 2023 Accepting new patients
Coastal Anesthesia, P.C. Anesthesiology Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

8946 Interline Ave
Ste C
Baton Rouge, LA 70809
Phone (225) 529-1143

3600 Florida St
Baton Rouge, LA 70806
Phone (225) 381-2615

7301 Hennessy Blvd
#100
Baton Rouge, LA 70808
Phone (225) 215-3443

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

694 Belle Terre Blvd
La Place, LA 70068
Phone (985) 359-6694

3900 N Causeway Blvd
Ste 625
Metairie, LA 70002
Phone (504) 262-9033

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

2701 Napoleon Ave
New Orleans, LA 70115
Phone (504) 267-2805

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

6550 Main St
Ste 2600
Zachary, LA 70791
Phone (225) 570-6357

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304985600000",
    "number": "1649211426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLETON",
        "first_name": "BERNARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2011-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "12795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.