Individual provider Active NPI

Barrett Eisenstat, M.D.

  • Dermatology Physician
  • Oceanside, NY
National Provider Identifier
1285631176
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
130692-2 Issued in NY
Practice address
258 Merrick Rd
Oceanside, NY 11572-1427
Phone
(516) 766-0345
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 130692-2 NY Primary

Addresses

Primary practice location

258 Merrick Rd
Oceanside, NY 11572-1427

Mailing address

258 Merrick Rd
Oceanside, NY 11572-1427
Phone (516) 766-0345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060103000533 NY Practitioner - Dermatology 6406878529 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
130692-2NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Nassau Dermatology P.C. Dermatology CurrentSince Jan 1, 1999 Accepting new patients

Locations

303 E Park Ave
Long Beach, NY 11561
Phone (516) 431-2020

200 E Eckerson Rd
New City, NY 10956
Phone (845) 352-0500

258 Merrick Rd
Oceanside, NY 11572
Phone (516) 766-0345

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1285631176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 MERRICK RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721427",
            "telephone_number": "516-766-0345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 MERRICK RD",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115721427",
            "telephone_number": "516-766-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENSTAT",
        "first_name": "BARRETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "130692-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.