DR. ALEXANDER M EISEN (DO) – Pediatrics Physician, NPI 1366490682
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. ALEXANDER M EISEN (DO)
1215 Lee St
Charlottesville, VA 229080816
Phone: (434) 924-5321
Type: Location
105 E Watts St
Enterprise, AL 363302511
Phone: (334) 393-5437
Fax: (334) 393-4185
Type: Location
1204 W MAIN ST
CHARLOTTESVILLE, VA 229032824
Phone: (434) 924-5321
Type: Location
1414, Elba Highway, Forest Acres Mobile Home Park, Troy, Pike County, Alabama, 36079, United States
TROY, AL 360796020
Phone: (334) 670-6726
Fax: (334) 670-6731
Type: Mailing
105, East Watts Street, Hillcrest, Enterprise, Coffee County, Alabama, 36330, United States
ENTERPRISE, AL 363302511
Phone: (334) 393-5437
Fax: (334) 393-4185
Type: Location
PO BOX 749112
ATLANTA, GA 303749112
Phone: (434) 295-1000
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-10-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180913002158 | I | Pediatric Medicine | DC | TBD |
| I20181002002018 | I | Pediatric Medicine | VA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 22908)
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