Eclipse Clinic PLLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

Legal business name

ECLIPSE CLINIC PLLC

Practice address

1006 Legacy Ranch Rd
104
Waxahachie, TX 75165

Phone

(817) 826-4604

NPI assigned

May 17, 2021

Last updated

May 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dustin Leek, MDNPI 1902291362

Title

Sole Member

Phone

(817) 526-4604

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: dustin.leek@eclipseclinic.com
• FHIR API: https://api.platform.athenahealth.com/22507/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/FHCCDD

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dustin Ryan Leek, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Waxahachie, TX
  • NPI 1902291362
  Medicare reassignment Care Compare group NPD Authorized official
• Ashley Elizabeth Hall, FNP-C

  • Family Nurse Practitioner
  • Waxahachie, TX
  • NPI 1992326102
  Medicare reassignment Care Compare group NPD
• Jose Angel Vazquez, PT

  • Physical Therapist
  • Mansfield, TX
  • NPI 1447407176
  Medicare reassignment Care Compare group NPD
• Diane Walker, APRN

  • Family Nurse Practitioner
  • Henderson, NV
  • NPI 1427467422

  TX

  Medicare reassignment Care Compare group NPD
• Dustin Clint Hendrix, DC

  • Chiropractor
  • Waxahachie, TX
  • NPI 1336636463
  Medicare reassignment NPD

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1710551585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 LEGACY RANCH RD",
            "address_2": "104",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "75165",
            "telephone_number": "817-826-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 LEGACY RANCH RD",
            "address_2": "104",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "75165",
            "telephone_number": "817-826-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECLIPSE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "LEEK",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "817-526-4604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15016694",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dustin.leek@eclipseclinic.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "address_1": "1006 Legacy Ranch Rd",
            "address_2": "104",
            "city": "Waxahachie",
            "state": "TX",
            "country_code": "US",
            "postal_code": "75165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Martin Durelle Eason, M.D.
• Eastland Memorial Hospital District (Pleasant Manor Healthcare and Rehabilitation)
• Eastland Memorial Hospital District (Legend Oaks Healthcare and Rehabilitation-Waxahachie)
• Amber Hanks Ebner, PA-C
• Demetria Danielle Polk Echols, M. ED
• Edward Lee Holt, DO, P.a.
• Edward Lee Holt, DO, P.a.
• Amy Lynn Edwards, PA-C
• Danielle Eichhorst
• Eirini Kai Agapi

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Waxahachie, TX
• Providers in Waxahachie, TX by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.