ENRIQUE ELLENBOGEN, M.D. INC (NPI# 1184870164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184870164 |
| Entity Type | Organization |
| Organization Name | ENRIQUE ELLENBOGEN, M.D. INC |
| Other Organization Name | ELLENBOGEN EYE CENTER |
| Practice Address |
700 S Stanfield Rd Suite B Troy OH 45373-2569 |
| Practice Telephone | 9373357121 |
| Practice Fax Number | 9373357124 |
| Mailing Telephone | 9373357121 |
| Mailing Fax Number | 9373357124 |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2008-08-22 |
| Authorized Official Name | MRS. DONNA JEAN ZIMMERMAN (OFFICE MANAGER) |
| Authorized Official Telephone | 9373357121 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 35100246 | OH | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | HUMANA | D00246 | 01 |
| OH | ANTHEM | 000000010310 | 01 |
| OH | L0277598 | 05 |
| Other Name | Type Code |
|---|---|
| Ellenbogen Eye Center | Other Name - Individual/Organization |
| Street Address |
700 S STANFIELD RD SUITE B |
| City | TROY |
| State | OH |
| Zip Code | 45373-2569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699764837 | Craig Critchley | Family Medicine | 700 S Stanfield Rd, Ste. A, Troy, OH 45373-2372 | 2005-10-20 |
| 1366813099 | Megan Bonk | Physician Assistant | 700 S Stanfield Rd, Ste. A, Troy, OH 45373-2373 | 2015-10-07 |
| 1770868697 | Jessica Lynne Stager | Physician Assistant | 700 S Stanfield Rd, Ste A, Troy, OH 45373-2569 | 2011-10-12 |
| 1255536819 | Carla Christine Garber | Nurse Practitioner | 700 S Stanfield Rd, Ste. A, Troy, OH 45373-2569 | 2007-06-15 |
| 1972671709 | Enrique Ellenbogen | Ophthalmology | 700 S Stanfield Rd, Suite B, Troy, OH 45373-2569 | 2006-12-01 |
| 1891785309 | Linda Davidson | Registered Nurse | 700 S Stanfield Rd, Ste. A, Troy, OH 45373-2372 | 2005-10-26 |
| 1710977244 | Upper Valley Family Care Inc | Family Medicine | 700 S Stanfield Rd, Troy, OH 45373-2372 | 2005-10-26 |
| 1740270248 | Christopher Cooley | Specialist | 700 S Stanfield Rd, Troy, OH 45373-2372 | 2005-10-26 |
| 1982693131 | Richard Plumb | Family Medicine | 700 S Stanfield Rd, Ste. A, Troy, OH 45373-2372 | 2005-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248336 | Julie M Anderson | Home Health Aide | 74 Tamworth Road, Troy, OH 45373 | 2020-09-05 |
| 1376007682 | Community Housing of Darke, Miami & Shelby Counties, Inc | Peer Specialist | 1100 Wayne Ave Suite 4001, Troy, OH 45373 | 2019-01-31 |
| 1861982423 | Omni Wellness Group LLC | Family Medicine | 1149 Experiment Farm Road, Troy, OH 45373 | 2018-05-18 |
| 1336638758 | Kristin Dolph | Counselor | 305 Public Sq, Troy, OH 45373 | 2018-05-02 |
| 1912425448 | Wanda Denise Hudson | Counselor | 550 Sumitt Ave, Troy, OH 45373 | 2017-09-05 |
| 1538685383 | Cassandra Ann Zerkle | Occupational Therapist | 2000 W. Stainfield Rd., Troy, OH 45373 | 2017-08-14 |
| 1891215224 | Michele Josefovsky | Nurse Practitioner | 31 S Stanfield Rd Ste 301, Troy, OH 45373 | 2017-06-27 |
| 1295271104 | Alison Moyer | Specialist/Technologist | 1852 Towne Park Dr Apt 6b, Troy, OH 45373 | 2017-01-17 |
| 1982151148 | Amanda Falldorf | Nurse Practitioner | 1843 W Main St, Troy, OH 45373 | 2016-09-06 |
| 1588093314 | Quad Med LLC | Clinic/Center | 1447 E. Main Street, Troy, OH 45373 | 2013-11-02 |
| Find all providers in zip 45373 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
| 1366000242 | Urology Associates PC | Clinic/Center | 1380 Coolidge Hwy Ste 220, Troy, MI 48084-7068 | 2019-06-05 |
| 1104303924 | Priority One Medical Care Pllc | Clinic/Center | 938 S Sanders Rd, Troy, TN 38260-3841 | 2018-07-24 |
| 1982181848 | Ec Concepts Group LLC | Clinic/Center | 912 E Big Beaver Rd, Troy, MI 48083-1410 | 2018-07-24 |
| 1972098895 | Somerset Walk In Clinic Pllc | Clinic/Center | 1500 W Big Beaver Rd Ste 104, Troy, MI 48084-3522 | 2018-06-22 |
| 1457669871 | Troy Regional Physicians Inc | Clinic/Center | 1320 Highway 231 South, Suite 1, Troy, AL 36081 | 2010-09-20 |
| 1356508907 | Agape Womens Health Plc | Clinic/Center | 575 E Maple Rd, Suite B, Troy, MI 48083-2827 | 2008-05-21 |
| 1932376993 | Jefrey Fishman, M.d. P.C. | Clinic/Center | 1777 Axtell Dr Ste 200, Troy, MI 48084-4435 | 2008-05-09 |
| 1588834279 | Medicine Tree Primary Care Inc | Clinic/Center | 318 E Kootenai Ave, Troy, MT 59935 | 2008-03-10 |
| 1841349511 | M Amin Zaman Md Sc | Clinic/Center | 500 Ohara Dr Ste 120, Troy, IL 62294-2316 | 2007-01-10 |
| 1346207131 | Charles Henderson Memorial Association | Clinic/Center | 1300 Highway 231 S, Troy, AL 36081-3058 | 2006-04-27 |
| Find all providers in TROY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.