Individual provider Active NPI

Ellen Harriet Eisenberg, M.D.

  • Internal Medicine Physician
  • Lebanon, NH
National Provider Identifier
1598793606
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME160421 Issued in FL
Practice address
1 Medical Center Dr
DHMC - Internal Medicine
Lebanon, NH 03756-1000
Phone
(603) 653-9500
Fax
(603) 650-0915
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12652 NH
Internal Medicine Physician 207R00000X ME160421 FL Primary

Addresses

Primary practice location

1 Medical Center Dr
DHMC - Internal Medicine
Lebanon, NH 03756-1000

Mailing address

1800 S Ocean Blvd Apt 8E
Boca Raton, FL 33432-8546
Phone (802) 356-5788

Other identifiers 2

IdentifierTypeStateIssuer
1008265MedicaidVT
30201546MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20050712001170 NH Practitioner - Internal Medicine 2466400403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME160421FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Internal Medicine CurrentSince Jul 1, 2005 Accepting new patients
Dartmouth-Hitchcock Clinic Internal Medicine CurrentSince Jul 1, 2005 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 1, 2005 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

32 Pleasant St
Woodstock, VT 05091
Phone (802) 457-3030

Interoperability endpoints

  • Direct secure messaging: ellen.eisenberg.1@26289.direct.athenahealth.com
  • Direct secure messaging: eeisenberg1613@direct.dartmouth-hitchcock.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1598793606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 S OCEAN BLVD APT 8E",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334328546",
            "telephone_number": "802-356-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC - INTERNAL MEDICINE",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-653-9500",
            "fax_number": "603-650-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "ELLEN",
        "middle_name": "HARRIET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "12652",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME160421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008265",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30201546",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.