Individual provider Active NPI

Amalia Arasula Eisenberg, A.R.N.P.

  • Acute Care Nurse Practitioner
  • Santa Monica, CA
National Provider Identifier
1255739835
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
19334 Issued in CA
Practice address
2121 Santa Monica Blvd
Providence St. John's Health Center
Santa Monica, CA 90404
Phone
(310) 582-7450
Fax
(310) 582-7495
NPI assigned
Dec 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 19334 CA Primary

Addresses

Primary practice location

2121 Santa Monica Blvd
Providence St. John's Health Center
Santa Monica, CA 90404

Mailing address

220 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 582-7450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240603001303 CA Practitioner - Nurse Practitioner 4587954607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Barry University School of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2125 Arizona Ave
Santa Monica, CA 90404-1337
Phone (310) 582-7450

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
96.07
Promoting interoperability
100
Improvement activities
40
Cost
71.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19334CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Apr 21, 2024 Accepting new patients
Saint John's Health Clinic Past Accepting new patients
Pacific Neuroscience Institute Medical Group Inc Past Accepting new patients

Locations

2125 Arizona Ave
Fl 2
Santa Monica, CA 90404

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2125 Arizona Ave
Santa Monica, CA 90404
Phone (310) 582-7450

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: aeisenberg472865@oc.providencedirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1255739835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 SANTA MONICA BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-582-7450",
            "fax_number": "310-582-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SANTA MONICA BLVD",
            "address_2": "PROVIDENCE ST. JOHN'S HEALTH CENTER",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-582-7450",
            "fax_number": "310-582-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "AMALIA",
        "middle_name": "ARASULA",
        "name_prefix": "Mrs.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-12",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "19334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.