Mary Anne Eisma

Primary specialty

Aerospace Medicine PhysicianTaxonomy code 2083A0100X

License

02003990A Issued in IN

Practice address

4175 S Alamo Ave
Davis Monthan Afb, AZ 85707-4402

Phone

(520) 228-2778

NPI assigned

Jan 28, 2010

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1264636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1831420900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 S ALAMO AVE",
            "city": "DAVIS MONTHAN AFB",
            "state": "AZ",
            "postal_code": "857074402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 S ALAMO AVE",
            "city": "DAVIS MONTHAN AFB",
            "state": "AZ",
            "postal_code": "857074402",
            "telephone_number": "520-228-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISMA",
        "first_name": "MARY ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-28",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "IN",
            "license": "02003990A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayme L Cline, IDMT
• Amanda Cook, DO
• Jason West Cromar, M.D., M.P.H.
• Angela C. Demaio, LCSW, LISAC
• Joel David Drallette, DO
• Cameron John Elward, MD
• Ciera Domonique Paige Espinosa, PHARMD
• Denise Fabian, M.D.
• Christopher Guerrero, LCSW
• Collin Douglas Holman, DDS

• Aerospace Medicine Physician in Davis Monthan Afb, AZ
• Providers in Davis Monthan Afb, AZ by specialty
• Aerospace Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.