EASTSIDE INTERNAL MEDICINE PC
NPI 1831201821
Internal Medicine in Saint Clair Shores, MI
About Eastside Internal Medicine Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EASTSIDE INTERNAL MEDICINE PC (NPI 1831201821) is a healthcare organization registered as an internal medicine in Saint Clair Shores, Michigan and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through July 29, 2028 and lists Lori Eckenwiler, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Eastside Internal Medicine Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Eastside Internal Medicine PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 23D1002150
Eastside Internal Medicine, PC · St Clair Shores, MIFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Eastside Internal Medicine PC's NPI number?
The NPI number for Eastside Internal Medicine PC is 1831201821. It was assigned to this organization in the NPPES registry on August 31, 2006.
Where is Eastside Internal Medicine PC located?
Eastside Internal Medicine PC is located at 28315 Harper Ave, Saint Clair Shores, MI 48081. The listed phone number is (586) 552-1710.
What is Eastside Internal Medicine PC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Eastside Internal Medicine PC enrolled in Medicare?
Yes. Eastside Internal Medicine PC is registered in the Medicare PECOS enrollment system.
When is Eastside Internal Medicine PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Eastside Internal Medicine PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Internal Medicine, reassign their Medicare billing to Eastside Internal Medicine PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Eastside Internal Medicine PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 23D1002150) is associated with this NPI, valid through July 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Eastside Internal Medicine PC accept?
Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Eastside Internal Medicine PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Eastside Internal Medicine PC was last updated on July 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Eastside Internal Medicine Pc · NPI 1831201821
Internal Medicine organization in Saint Clair Shores, Michigan. Organization record, active in the CMS NPPES registry since August 31, 2006.
## Identity
- **NPI:** 1831201821 (Entity type: Organization)
- **Enumerated:** August 31, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Lori Eckenwiler, OFFICE MANAGER
## Practice location
- **Address:** 28315 HARPER AVE, Saint Clair Shores, MI 48081-1687
- **Phone:** (586) 552-1710 · **Fax:** (586) 552-1715
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 3 clinicians (Internal Medicine) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 21, 2011
- **Other identifiers:** Medicare PIN 0N51910 (MI)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1831201821) · Data from the CMS NPPES public registry.