Individual provider Active NPI

Eliane Festa Eakin, MD PHD

  • Pediatric Pulmonology Physician
  • Philadelphia, PA
National Provider Identifier
1902860554
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
MD068646L Issued in PA
Practice address
160 E Erie Ave
Philadelphia, PA 19134-1011
Phone
(484) 628-1324
NPI assigned
Apr 12, 2006
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C145488 CA
Pediatric Pulmonology Physician 2080P0214X C145488 CA
Pediatric Pulmonology Physician 2080P0214X MD.43855 AL
Pediatric Pulmonology Physician 2080P0214X MD068646L PA Primary

Addresses

Primary practice location

160 E Erie Ave
Philadelphia, PA 19134-1011

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-1324

Other practice location 1

1601 Center St
Mobile, AL 36604-1541
Phone (251) 410-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL, PA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20090825000562 MS Practitioner - Pediatric Medicine 4284607805 Reassigns benefits to 1 organization
I20220301000770 AL Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 4284607805 Reassigns benefits to 1 organization
I20240306001174 PA Practitioner - Pulmonary Disease 4284607805 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C145488CAMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Care Clinic, Inc. Current Accepting new patients
STC Pediatrics LLC Pediatrics Current Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Apr 24, 2024 Accepting new patients
USA Health Physician Billing Services LLC CurrentSince Mar 1, 2022 Accepting new patients
Family Health Care Clinic, Inc. CurrentSince Oct 23, 2016 Accepting new patients
USA Health Physician Billing Services LLC Pediatrics CurrentSince Mar 1, 2022 Accepting new patients
STC Pediatrics LLC Pediatrics CurrentSince Apr 24, 2024 Accepting new patients
Family Health Care Clinic, Inc. CurrentSince Oct 23, 2016 Accepting new patients
Rene Salhab MD Inc Pediatrics PastSince Apr 1, 2020 Accepting new patients
The Children's Clinic PC Past Accepting new patients

Locations

1601 Center St
Mobile, AL 36604
Phone (251) 410-5437

75 S University Blvd
Unit 6000
Mobile, AL 36608
Phone (251) 660-5555

75 S University Blvd
Unit 6500
Mobile, AL 36608
Phone (251) 445-8282

1551 W Government St
Brandon, MS 39042
Phone (601) 825-3163

290 Highway 51 N
Brookhaven, MS 39601
Phone (601) 823-1710

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-5202

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: eeakin845513@direct.memorialcare.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1902860554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "484-628-1324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Center St",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366041541",
            "country_code": "US",
            "telephone_number": "251-410-5437",
            "fax_number": "251-434-3876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EAKIN",
        "first_name": "ELIANE",
        "middle_name": "FESTA",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C145488",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "CA",
            "license": "C145488",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "AL",
            "license": "MD.43855",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "PA",
            "license": "MD068646L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.