Samuel Eisens, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL 2169 Issued in FL

Practice address

901 S Flagler Dr
West Palm Beach, FL 33401-6505

Phone

(561) 803-2338

NPI assigned

Oct 16, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Palm Beach Atlantic University

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • West Palm Beach, FL
  • NPI 1689044687

  Athletic Trainer

  NPD (past)

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1104297050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 WINDING ROSE WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334154479",
            "telephone_number": "336-213-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S FLAGLER DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334016505",
            "telephone_number": "561-803-2338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENS",
        "first_name": "SAMUEL",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-16",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 2169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Ehrbar
• Jillian Eicholtz
• Dov I Eidelman, MD
• Elizabeth Sarah Eisenberg
• Rachel Eisenberg, ARNP
• David Eisner, DDS
• Celia Nicole Eissey, LMHC
• El de'OT Center Inc
• El Elyon Medpsych Services
• El Jardin del Eden Alf Inc

• Athletic Trainer in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.