Individual provider Active NPI

David Eisenberg, MD

  • Surgery Physician
  • Hartford, CT
National Provider Identifier
1366650038
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD431341 Issued in PA
Practice address
85 Seymour St
Suite 700
Hartford, CT 06106-5501
Phone
(860) 696-2040
Fax
(860) 696-2050
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD431341 PA Primary

Addresses

Primary practice location

85 Seymour St
Suite 700
Hartford, CT 06106-5501

Mailing address

85 Seymour St
Suite 700
Hartford, CT 06106-5501
Phone (860) 696-2040

Other identifiers 7

IdentifierTypeStateIssuer
047715OtherCTCONNECTICARE
9956346OtherCTAETNA
1366650038MedicaidCT
P4028960OtherCTOXFORD
46291OtherCTHEALTH NEW ENGLAND
061200871OtherCTCIGNA
061200871OtherCTMULTIPLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20090803000438 CT Practitioner - Surgical OncologyPractitioner - General Surgery 4486753969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
New York University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

85 Seymour St
Suite 700
Hartford, CT 06106-5533
Phone (860) 696-2040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy24
Melanoma (skin cancer) excision26
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD431341PAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC Surgery CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Hartford Healthcare Medical Group, Inc Surgery CurrentSince Jan 1, 2013 Accepting new patients
Hartford Clinical Associates, P.C. Surgery Past Accepting new patients

Locations

85 Seymour St
Ste 700
Hartford, CT 06106
Phone (860) 246-2277

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • Direct secure messaging: david.eisenberg@xdr.hhchealthdirect.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1366650038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "address_2": "SUITE 700",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065501",
            "telephone_number": "860-696-2040",
            "fax_number": "860-696-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SEYMOUR ST",
            "address_2": "SUITE 700",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061065501",
            "telephone_number": "860-696-2040",
            "fax_number": "860-696-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD431341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "047715",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9956346",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366650038",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P4028960",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NEW ENGLAND",
            "identifier": "46291",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "061200871",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "061200871",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.