Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1972671709 Individual Practitioner Male Practitioner

Dr. Enrique Ellenbogen , MD

Ophthalmology • Troy, OH

Professional Overview & Biography Verified Profile Summary

Dr. Enrique Ellenbogen, MD is a registered healthcare professional specializing in Ophthalmology in Troy, OH. Practice services are available at 700 S STANFIELD RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

700 S Stanfield Rd
Suite B

Troy, OH 453732569

Telephone 9373357121
Fax 9373357124
Associated Practice Facility / Clinic
🏢 Upper Valley Family Care Inc Facility NPI 1710977244

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Troy, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 26.0 Yrs
State Avg: 27.9 Yrs
Regional Practice Density
2 Specialists

Practicing in Troy, OH (803 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License OH 35100246

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
L0277598 (OH)
Commercial Insurance / Payer ID Anthem
000000010310
Commercial Insurance / Payer ID Tax Identification Number
311024334 (OH)
Commercial Insurance / Payer ID Humana
D00246

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Carla Garber , CNP

Nurse Practitioner - Family

NPI 1255536819

Certified Nurse Practitioner

NPI 1699764837

Doctor of Osteopathic Medicine (D.O.)

NPI 1740270248

Physical Therapist

Linda Davidson , RN-CNP

Nurse Practitioner - Gerontology

NPI 1891785309

RNCNP

Dr. Richard Plumb , DO

Family Medicine

NPI 1982693131

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 18, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location January 18, 2012

Registered at 700 S STANFIELD RD, SUITE B, TROY, OH 453732569 (Tel: 9373357121)

📍
Updated Business Mailing Address January 18, 2012

Registered at 700 S STANFIELD RD, SUITE B, TROY, OH 453732569 (Tel: 9373357121)

👤
Provider Name / Credentials Updated January 18, 2012

Recorded as ENRIQUE ELLENBOGEN, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 18, 2012

Ophthalmology (License #35100246 in OH)

🟢
Initial NPI Registration & Enumeration December 01, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1972671709
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 01, 2006
Last Update: January 18, 2012
Sole Proprietor: Yes

Mailing Address

700 S Stanfield Rd, Suite B

Troy, OH 453732569

Phone: 9373357121

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.