Individual provider Active NPI

Ernie Paul Eisenberg, D.C.

  • Chiropractor
  • Massapequa, NY
National Provider Identifier
1316026503
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X005574 Issued in NY
Practice address
627A Broadway
Massapequa, NY 11758-5030
Phone
(516) 798-5588
Fax
(516) 798-8145
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X005574 NY Primary

Addresses

Primary practice location

627A Broadway
Massapequa, NY 11758-5030

Mailing address

627A Broadway
Massapequa, NY 11758-5030
Phone (516) 798-5588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000673 NY Practitioner - Chiropractic 2264607811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

627 A Broadway
Massapequa, NY 11758-5030
Phone (516) 798-5588

627 A Broadway
Massapequa, NY 11758-5031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X005574NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ernie Eisenberg DC PC Chiropractor CurrentSince Oct 1, 1984 Accepting new patients

Locations

627A Broadway
Massapequa, NY 11758
Phone (516) 692-0037

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316026503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627A BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585030",
            "telephone_number": "516-798-5588",
            "fax_number": "516-798-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627A BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117585030",
            "telephone_number": "516-798-5588",
            "fax_number": "516-798-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "ERNIE",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X005574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.