Daniel D Eisenman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003084 Issued in GA

Practice address

705 Jesse Jewell Pkwy SE
Suite 175
Gainesville, GA 30501-3867

Phone

(770) 718-9790

Fax

(770) 718-5531

NPI assigned

May 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Texas Southwestern Medical School at Dallas, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Daniel Eisenman LLC

  • Clinical Neuropsychologist
  • Johns Creek, GA
  • NPI 1891073797
  Medicare reassignment NPD Authorized official
• Atlanta Clinical Health Group

  • Clinical Neuropsychologist
  • Snellville, GA
  • NPI 1194757492
  NPD (past)
• Psychiatry and Psychological Associates LLC

  • Psychologist
  • Gainesville, GA
  • NPI 1124038187
  NPD (past)

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1376757856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 175",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013867",
            "telephone_number": "770-718-9790",
            "fax_number": "770-718-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 175",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013867",
            "telephone_number": "770-718-9790",
            "fax_number": "770-718-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENMAN",
        "first_name": "DANIEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "GRP7811",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Edwards, PT, DPT
• Natalie Edwards, PT, DPT
• Toni O'Reggio Egolum, M.D.
• Ugochukwu Onyibo Egolum, MD
• Ehi Pharmacy Solutions, LLC.
• Sohail Ejaz, MD
• Tosan Betina Ejutse, MD
• Nagwa Elamin, DDS
• Elben RX Inc
• Jeff O Elder, MD

• Clinical Psychologist in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; 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.
• 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.