NPIMap

Individual provider Active NPI

Thomas D Eisen, MD

  • Nephrology Physician
  • New Haven, CT
National Provider Identifier
1427044684
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
28182 Issued in CT
Practice address
136 Sherman Ave
Suite 405
New Haven, CT 06511-5238
Phone
(203) 787-0117
Fax
(203) 777-3559
NPI assigned
Sep 23, 2005
Last updated
Oct 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 28182 CT Primary

Addresses

Primary practice location

136 Sherman Ave
Suite 405
New Haven, CT 06511-5238

Mailing address

136 Sherman Ave
Suite 405
New Haven, CT 06511-5238
Phone (203) 787-0117

Other identifiers 1

IdentifierTypeStateIssuer
001281823MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100728001178 CT Practitioner - NephrologyPractitioner - Internal Medicine 6305900713 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
New York University Medical College - NLG, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Metabolism Associates PCGroup PAC ID 2668466244, 9 clinicians

Practice addresses (Care Compare)

136 Sherman Ave
New Haven, CT 06511-5210
Phone (203) 787-0117

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
72.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28182CTMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jun 1, 2021 Accepting new patients
Yale University Current Accepting new patients
Yale University CurrentSince Jun 1, 2021 Accepting new patients
Metabolism Associates PC Nephrology CurrentSince Jul 28, 2001 Accepting new patients

Locations

1354 Chapel St
New Haven, CT 06511
Phone (203) 867-8300

136 Sherman Ave
Ste 405
New Haven, CT 06511
Phone (203) 483-4535

136 Sherman Ave
Ste 502
New Haven, CT 06511
Phone (203) 272-1811

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

Interoperability endpoints

  • Direct secure messaging: teisen3022@direct.ynhh.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1427044684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 SHERMAN AVE",
            "address_2": "SUITE 405",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115238",
            "telephone_number": "203-787-0117",
            "fax_number": "203-777-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 SHERMAN AVE",
            "address_2": "SUITE 405",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115238",
            "telephone_number": "203-787-0117",
            "fax_number": "203-777-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISEN",
        "first_name": "THOMAS",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CT",
            "license": "28182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001281823",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.