NPIMap

Individual provider Active NPI

Michael Eubanks, NP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1477008969
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F3078021 Issued in NY
Practice address
51 W 51St St
New York, NY 10019-6113
Phone
(212) 326-5705
NPI assigned
Aug 24, 2016
Last updated
May 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F3078021 NY Primary
Gerontology Nurse Practitioner 363LG0600X F3078021 NY

Addresses

Primary practice location

51 W 51St St
New York, NY 10019-6113

Mailing address

51 W 51St St
New York, NY 10019-6113
Phone (212) 326-5705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20170126000438 NY Practitioner - Nurse Practitioner 4981985819 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Colorado School of Medicine, Denver, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

52 Meadows St
Pearl River, NY 10965-1912
Phone (212) 980-4294

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F3078021NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients
Adult Health Nurse Practitioner House Call Services, PLLC Adult Health CurrentSince Jul 1, 2025 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 14, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 12, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 3, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 14, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Dec 12, 2016 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Oct 17, 2023 Accepting new patients
Trustees of Columbia University in the City of New York PastSince Oct 1, 2015 Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 9

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 2

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": "1471996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1477008969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 W 51ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100196113",
            "telephone_number": "212-326-5705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 W 51ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100196113",
            "telephone_number": "212-326-5705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUBANKS",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-24",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F3078021",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F3078021",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.