Individual provider Active NPI

Eric G. Huish, D.O.

  • Obstetrics & Gynecology Physician
  • Gilbert, AZ
National Provider Identifier
1790777969
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2318 Issued in AZ
Practice address
4915 E Baseline Rd Ste 126
Gilbert, AZ 85234-2969
Phone
(480) 969-3096
Fax
(480) 969-0963
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2318 AZ Primary

Addresses

Primary practice location

4915 E Baseline Rd Ste 126
Gilbert, AZ 85234-2969

Mailing address

PO Box 748860
Atlanta, GA 30374-8860
Phone (480) 969-3096

Other identifiers 1

IdentifierTypeStateIssuer
049553MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051005000543 AZ Practitioner - Obstetrics/Gynecology 0143255471 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2318AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Care Arizona, LLC CurrentSince Apr 10, 2022 Accepting new patients
Banner Gateway Medical Center Past Accepting new patients

Locations

10815 W McDowell Rd
Ste 301
Avondale, AZ 85392
Phone (623) 433-0106

4915 E Baseline Rd
Ste 126
Gilbert, AZ 85234
Phone (480) 745-3690

Organizations & group practices 2

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1790777969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748860",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748860",
            "telephone_number": "480-969-3096",
            "fax_number": "480-969-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 E BASELINE RD STE 126",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342969",
            "telephone_number": "480-969-3096",
            "fax_number": "480-969-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUISH",
        "first_name": "ERIC",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "2318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049553",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.