Individual provider Active NPI

Shane Cameron Eizember, MD

  • Orthopaedic Surgery of the Spine Physician
  • San Antonio, TX
National Provider Identifier
1720434624
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
T6225 Issued in TX
Practice address
11212 State Highway 151 Ste 150
San Antonio, TX 78251-4505
Phone
(210) 630-4645
Fax
(210) 630-4646
NPI assigned
May 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X T6225 TX
Orthopaedic Surgery of the Spine Physician 207XS0117X T6225 TX Primary

Addresses

Primary practice location

11212 State Highway 151 Ste 150
San Antonio, TX 78251-4505

Mailing address

400 Concord Plaza Dr Ste 300
San Antonio, TX 78216-6991
Phone (210) 804-5416

Other practice location 1

400 Concord Plaza Dr Ste 300
San Antonio, TX 78216-6991
Phone (210) 630-4645

Other practice location 2

3327 Research Plz Ste 215
San Antonio, TX 78235-5157
Phone (210) 630-4645

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

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
I20220819000484 TX Practitioner - Orthopedic Surgery 0143518415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11212 State Hwy 151
Suite 150
San Antonio, TX 78251-4505
Phone (210) 804-5400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.86 of 100Reported as group
Quality
65.93
Promoting interoperability
94
Improvement activities
40
Cost
71.93

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion89
Laminectomy or laminotomy (partial removal of spine bones)11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T6225TXMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The San Antonio Orthopaedic Group, LLP Orthopaedic Surgery CurrentSince Sep 1, 2022 Accepting new patients
The San Antonio Orthopaedic Group, LLP Orthopaedic Surgery CurrentSince Sep 1, 2022 Accepting new patients
Trinity Regional Medical Center Orthopaedic Surgery Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

400 Concord Plaza Dr
Ste 300
San Antonio, TX 78216
Phone (210) 804-5416

11212 State Highway 151
Ste 150
San Antonio, TX 78251
Phone (210) 233-1215

3327 Research Plz
Ste 215
San Antonio, TX 78235
Phone (210) 396-5285

1200 Brooklyn Ave
Ste 320
San Antonio, TX 78212
Phone (210) 225-5741

Interoperability endpoints

  • Direct secure messaging: shane.eizember.1@94.direct.athenahealth.com
  • Direct secure messaging: shane.eizember.1@3199.direct.athenahealth.com

Organizations & group practices 3

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": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1720434624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CONCORD PLAZA DR STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166991",
            "telephone_number": "210-804-5416",
            "fax_number": "210-678-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11212 STATE HIGHWAY 151 STE 150",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514505",
            "telephone_number": "210-630-4645",
            "fax_number": "210-630-4646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Concord Plaza Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782166991",
            "country_code": "US",
            "telephone_number": "210-630-4645",
            "fax_number": "210-630-4646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3327 Research Plz Ste 215",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782355157",
            "country_code": "US",
            "telephone_number": "210-630-4645",
            "fax_number": "210-630-4646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EIZEMBER",
        "first_name": "SHANE",
        "middle_name": "CAMERON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-10",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "T6225",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TX",
            "license": "T6225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.