NPIMap

Individual provider Active NPI

Eleonor Eustace

  • Internal Medicine Physician
  • Brewster, NY
National Provider Identifier
1558723809
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1696095 Issued in NY
Practice address
3423 Danbury Rd
Brewster, NY 10509-4513
Phone
(845) 279-7200
Fax
(203) 739-1883
NPI assigned
Mar 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 66910 CT
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 1696095 NY Primary

Addresses

Primary practice location

3423 Danbury Rd
Brewster, NY 10509-4513

Mailing address

3423 Danbury Rd
Brewster, NY 10509-4513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210506001301 CT Practitioner - Internal Medicine 5193024479 Reassigns benefits to 1 organization
I20220104000667 NY Practitioner - Internal Medicine 5193024479 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eastern New York Medical Services PCGroup PAC ID 6901049600, 4 clinicians

Practice addresses (Care Compare)

3423 Danbury Rd
Brewster, NY 10509-4513
Phone (845) 279-7200

Hospital & facility affiliations

  • VNS Westchester Chha Home health agency, White Plains, NY, CCN 337146
  • Rvnahealth Home health agency, Ridgefield, CT, CCN 077066
  • Danbury Hospital Hospital, Danbury, CT, CCN 070033
  • Putnam Hospital Center Hospital, Carmel, NY, CCN 330273
  • Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2021 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jun 1, 2021 Accepting new patients
Eastern New York Medical Services PC Internal Medicine CurrentSince Jan 15, 2022 Accepting new patients
Nuvance Health Medical Practice CT, Inc. Internal Medicine PastSince Jan 15, 2022 Accepting new patients

Locations

761 Main Ave
Ste 201
Norwalk, CT 06851
Phone (203) 838-4000

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

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

3423 Danbury Rd
Brewster, NY 10509
Phone (845) 279-7200

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 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": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1558723809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3423 DANBURY RD",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3423 DANBURY RD",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105094513",
            "telephone_number": "845-279-7200",
            "fax_number": "203-739-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUSTACE",
        "first_name": "ELEONOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "66910",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1696095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

Verify at the official NPI Registry.