NPIMap

Organization Active NPI

Northstar Anesthesia of Michigan PLLC

  • Anesthesiology Physician
  • Irving, TX
National Provider Identifier
1871986372
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NORTHSTAR ANESTHESIA OF MICHIGAN PLLC
Practice address
6225 N State Highway 161 Ste 200
Irving, TX 75038-2241
Phone
(214) 687-0675
NPI assigned
Mar 9, 2015
Last updated
May 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Authorized official

Name
Philip W Eichenholz, MD
Title
President
Phone
(214) 687-0008

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

6225 N State Highway 161 Ste 200
Irving, TX 75038-2241

Mailing address

6225 N State Highway 161 Ste 200
Irving, TX 75038-2241
Phone (239) 610-0775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150707000070 MI Part B Supplier - Clinic/Group Practice 9638481591 Receives reassigned benefits from 363 practitioners
Practice locations: Detroit, MI; Flint, MI; Farmington Hills, MI; Commerce Township, MI

National Provider Directory

National Provider Directory

Locations

311 Mack Ave
Detroit, MI 48201
Phone (313) 745-8792

Practitioners & affiliated clinicians

Practitioners 368

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.

View all 368

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1871986372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 N STATE HIGHWAY 161 STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382241",
            "telephone_number": "239-610-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 N STATE HIGHWAY 161 STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382241",
            "telephone_number": "214-687-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR ANESTHESIA OF MICHIGAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-09",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "EICHENHOLZ",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-687-0008",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.