NPIMap

Individual provider Active NPI

Phillip S Eisenberg, D.O.

  • Internal Medicine Physician
  • Traverse City, MI
National Provider Identifier
1619075637
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101010790 Issued in MI
Practice address
1000 Pavillions Cir
Traverse City, MI 49684
Phone
(231) 932-3000
Fax
(231) 932-3719
NPI assigned
Sep 21, 2006
Last updated
Aug 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101010790 MI Primary

Addresses

Primary practice location

1000 Pavillions Cir
Traverse City, MI 49684

Mailing address

10850 E Traverse Hwy Ste 4400
Traverse City, MI 49684-1320
Phone (231) 346-6800

Other identifiers 1

IdentifierTypeStateIssuer
4282710MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20060207000695 MI Practitioner - Internal Medicine 7012958333 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Care Medical Group of Mi, PLLCGroup PAC ID 5294075040, 8 clinicians
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians

Practice addresses (Care Compare)

16260 Park Lake Rd
East Lansing, MI 48823-9480
Phone (517) 325-5369

1901 Plymouth Rd
Ann Arbor, MI 48105-2277
Phone (734) 741-9500

1948 Cooper St
Jackson, MI 49202-1710
Phone (517) 990-6688

5025 Ann Arbor Rd
Jackson, MI 49201-8801
Phone (517) 879-1505

6429 Earlington LN
Lansing, MI 48917-8279
Phone (517) 589-4770

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101010790MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Michigan, PLLC Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients
Hospitalist Medicine Physicians of Michigan PLLC Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Internal Medicine CurrentSince May 30, 2019 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC Internal Medicine CurrentSince May 30, 2019 Accepting new patients
Inpatient Consultants of Michigan PC Internal Medicine CurrentSince Jul 13, 2011 Accepting new patients
Progressive Care Medical Group of Mi, PLLC Internal Medicine CurrentSince Jan 5, 2020 Accepting new patients
Faith Haven Senior Care Centre, LLC Past Accepting new patients
Progressive Health Care, P.C. Internal Medicine PastSince Feb 15, 2013 Accepting new patients
Tallahasse Care, Inc Past Accepting new patients
Capital Area Opco LLC Past Accepting new patients
Jackson Opco, LLC Past Accepting new patients
East Lansing Opco LLC Past Accepting new patients
Personal Health Care, P.C. Internal Medicine Past Accepting new patients
Powerback Rehabilitation LLC Past Accepting new patients
Lansing Opco, LLC Past Accepting new patients
Ingham County Medical Care Facility Past Accepting new patients
Okemos Opco, LLC Past Accepting new patients

Locations

22600 W Main St
Armada, MI 48005
Phone (734) 508-4569

1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

2815 Northwind Dr
East Lansing, MI 48823
Phone (517) 332-0817

5250 Marsh Rd
Haslett, MI 48840
Phone (517) 349-2662

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

1948 Cooper St
Jackson, MI 49202
Phone (517) 782-1900

434 W North St
Jackson, MI 49202
Phone (517) 787-3250

703 Robinson Rd
Jackson, MI 49203
Phone (517) 787-0722

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

1000 Pavilions Cir
Traverse City, MI 49684
Phone (231) 932-3000

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

625 36th St SW
Wyoming, MI 49509
Phone (517) 481-3715

150 Eileen Way
Unit 1
Syosset, NY 11791
Phone (516) 855-5255

Interoperability endpoints

  • Direct secure messaging: peisenberg940003@direct.hfhs.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Heart to Heart Hospice of Kalamazoo, LLCKalamazoo, MI, CCN 231736 Hospice Contracted Managing Employee Apr 7, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1619075637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 E TRAVERSE HWY STE 4400",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496841320",
            "telephone_number": "231-346-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PAVILLIONS CIR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-932-3000",
            "fax_number": "231-932-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "PHILLIP",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101010790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4282710",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.