Jessica Marie Eiser, M.D.
Individual provider Active NPI Pediatrics Physician · Fort Wainwright, AK
NPI 1922545052 · NPPES record last updated Jun 22, 2023
Key facts
- NPI
- 1922545052
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 0101266186 (VA)
- Practice address
- 4076 Neely Road
Fort Wainwright, AK 99703-0441 - Phone
- (907) 361-4001
- NPI assigned
- Jan 26, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241024002678 | TX | Practitioner - Pediatric Medicine | 1052844339 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101266186 | VA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanana Chiefs Conference | Current |
Accepting new patients | |
| Tanana Chiefs Conference | Current |
Accepting new patients |
Locations
122 1st Ave
Ste 106
Fairbanks, AK 99701
Interoperability endpoints
- jessica.eiser.1@15989.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 0101266186 | VA | |
| Pediatrics Physician | 208000000X | 0101266186 | VA | Yes |
Addresses
Primary practice location
4076 Neely Road
Fort Wainwright, AK 99703-0441
Mailing address
3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-3160
Other providers in Fort Wainwright, AK
- Barbara L Drake
- Aimee Duncan
- Geoffrey Duncklee
- Harley Dungee
- Charity Letitia Edwards
- Julie Englert
- Lena Marie Fabian
- Karen Anne Fell
- John Michael Fierro
- Levi Daniel Fisher
All providers in Fort Wainwright, AK · Pediatrics Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.