Individual provider Active NPI

Barry I Eisenberg, DO

  • Family Medicine Physician
  • Scranton, PA
National Provider Identifier
1033164157
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS002883L Issued in PA
Practice address
743 Jefferson Ave
Ste 104
Scranton, PA 18510
Phone
(570) 346-4621
Fax
(570) 346-5109
NPI assigned
May 24, 2006
Last updated
Dec 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS002883L PA Primary

Addresses

Primary practice location

743 Jefferson Ave
Ste 104
Scranton, PA 18510

Mailing address

743 Jefferson Ave
Ste 104
Scranton, PA 18510
Phone (570) 346-4621

Other identifiers 1

IdentifierTypeStateIssuer
0015091060006MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1033164157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 JEFFERSON AVE",
            "address_2": "STE 104",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18510",
            "telephone_number": "570-346-4621",
            "fax_number": "570-346-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 JEFFERSON AVE",
            "address_2": "STE 104",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18510",
            "telephone_number": "570-346-4621",
            "fax_number": "570-346-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "BARRY",
        "middle_name": "I",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS002883L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015091060006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.