Active NPI
Kenneth Eichenbaum, MD
- Anesthesiology Physician
- Troy, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301108718
- Practice address
- 44201 Dequindre Rd
Troy, MI 48085-1117 - Phone
- (248) 964-5000
- NPI assigned
- May 21, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A124518 | CA | |
| Anesthesiology Physician | 207L00000X | 4301108718 | MI | Primary |
Addresses
Primary practice location
44201 Dequindre Rd
Troy, MI 48085-1117
Mailing address
PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839
Other practice location 1
300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Icahn School of Medicine at Mount Sinai, 2009
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
16815 E Jefferson Ave
Suite 1030
Grosse Pointe, MI 48230-1923
Phone (214) 687-0001
44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 585-3023
Hospital & facility affiliations
- Trinity Health Oakland Hospital
- Beaumont Hospital Royal Oak
Merit-based Incentive Payment System (MIPS)
- Final score
- 67.5 of 100
- Quality
- 58.12
- Improvement activities
- 40
- Cost
- 68.45
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124518 | CA | MD | Social Worker |
| A124518 | CA | MD | Anesthesiology Physician |
| 4301108718 | MI | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Michigan III PLLC | Current | Accepting new patients | |
| Anesthesia Associates of Ann Arbor, PLLC | Anesthesiology | Current | Accepting new patients |
Locations
2006 Hogback Rd
Ste 5
Ann Arbor, MI 48105
Phone (313) 712-4331
16815 E Jefferson Ave
Ste 1030
Grosse Pointe, MI 48230
620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450
44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000
3601 W 13 Mile Rd
Royal Oak, MI 48073
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042
Interoperability endpoints
- keichenbaum1337057@direct.trinity-health.org
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.
-
- Anesthesiology Physician
- Westland, MI
- NPI 1669581997
-
- Pain Medicine (Anesthesiology) Physician
- Irving, TX
- NPI 1972126209
MI
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Pontiac, MI
- NPI 1053356352
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1962637892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 551420",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333551420",
"telephone_number": "800-243-3839",
"fax_number": "844-414-8291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44201 DEQUINDRE RD",
"city": "TROY",
"state": "MI",
"postal_code": "480851117",
"telephone_number": "248-964-5000"
}
],
"practiceLocations": [
{
"address_1": "300 Pasteur Dr",
"address_purpose": "LOCATION",
"city": "Stanford",
"state": "CA",
"postal_code": "943052200",
"country_code": "US",
"telephone_number": "650-723-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EICHENBAUM",
"first_name": "KENNETH",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-05-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A124518",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301108718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.