Active NPI
Samuel Casey Eisenberg
- Student in an Organized Health Care Education/Training Program
- Manhasset, NY
National Provider Identifier
1336889922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 300 Community Dr
Manhasset, NY 11030-3876 - Phone
- (516) 562-4764
- Fax
- (516) 562-3555
- NPI assigned
- Mar 31, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
300 Community Dr
Manhasset, NY 11030-3876
Mailing address
6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (104) 933-2704
Other practice location 1
27005 76th Ave
New Hyde Park, NY 11040-1496
Phone (718) 470-7000
Other practice location 2
1800 Orleans St
Baltimore, MD 21287-0010
Phone (410) 022-0375
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250616000513 | MD | Order and Referring Only - Pulmonary Disease | 1456862630 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648684800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748995200000",
"number": "1336889922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6201 GREENLEIGH AVE",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212202004",
"telephone_number": "104-933-2704",
"fax_number": "410-500-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 COMMUNITY DR",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110303876",
"telephone_number": "516-562-4764",
"fax_number": "516-562-3555"
}
],
"practiceLocations": [
{
"address_1": "27005 76th Ave",
"address_purpose": "LOCATION",
"city": "New Hyde Park",
"state": "NY",
"postal_code": "110401496",
"country_code": "US",
"telephone_number": "718-470-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1800 Orleans St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212870010",
"country_code": "US",
"telephone_number": "410-022-0375",
"fax_number": "410-955-0737",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EISENBERG",
"first_name": "SAMUEL",
"middle_name": "CASEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-31",
"last_updated": "2025-06-04",
"certification_date": "2025-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhasset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.