Tammy Lynn Eisentrout, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34007772E Issued in OH

Practice address

4048 Dressler Rd NW
Suite 203
Canton, OH 44718-2784

Phone

(330) 478-4132

Fax

(330) 478-3341

NPI assigned

Apr 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aultman North Canton Medical GroupGroup PAC ID 4082605266, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aultman Hospital Hospital, Canton, OH, CCN 360084
• Alliance Community Hospital Hospital, Alliance, OH, CCN 360131

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Aultman North Canton Medical Group

  • Multi-Specialty Clinic/Center
  • North Canton, OH
  • NPI 1245257088
  Medicare reassignment Care Compare group NPD
• North Canton Medical Foundation

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • North Canton, OH
  • NPI 1649383340
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alliance Community Hospital

  • General Acute Care Hospital
  • Alliance, OH
  • NPI 1942385794
  Care Compare affiliation
• Aultman Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1356366991
  Care Compare affiliation

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1669437844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 DRESSLER RD NW",
            "address_2": "STE 203",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182784",
            "telephone_number": "330-478-4132",
            "fax_number": "330-478-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 DRESSLER RD NW",
            "address_2": "SUITE 203",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182784",
            "telephone_number": "330-478-4132",
            "fax_number": "330-478-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENTROUT",
        "first_name": "TAMMY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34007772E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE PROVIDER #",
            "identifier": "000000328557",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "000000328557",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE PROVIDER #",
            "identifier": "200830551028",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDE",
            "identifier": "P00221584",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2430640",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEY PROVIDER #",
            "identifier": "733255",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Canton, OH
• Providers in Canton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.
• 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.