Theodore E Eisenstat, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

25MA024994100 Issued in NJ

Practice address

3900 Park Ave
Suite 101
Edison, NJ 08820-3032

Phone

(732) 494-6640

Fax

(732) 549-8204

NPI assigned

Jan 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: teisenstat17701@epicdirect.rwjbh.org

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.

• Rutgers Health-RWJ Neurosurgery Faculty

  • Surgery Physician
  • Somerville, NJ
  • NPI 1548356926
  Medicare reassignment NPD
• Rutgers Health-RWJ Neurosurgery Faculty

  • Urology Physician
  • New Brunswick, NJ
  • NPI 1710012604
  Medicare reassignment NPD
• Associated Colon & Rectal Surgeons, P.a.

  • Specialist
  • Edison, NJ
  • NPI 1033297890
  NPD
• Rutgers Health-RWJ Neurosurgery Faculty

  • Durable Medical Equipment & Medical Supplies
  • Neptune, NJ
  • NPI 1861290744
  NPD
• Practice Associates Medical Group

  dba Atlantic Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385
  NPD (past)

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1619948536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 PARK AVE",
            "address_2": "SUITE 101",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203032",
            "telephone_number": "732-494-6640",
            "fax_number": "732-549-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 PARK AVE",
            "address_2": "SUITE 101",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203032",
            "telephone_number": "732-494-6640",
            "fax_number": "732-549-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENSTAT",
        "first_name": "THEODORE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA02494100",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NJ",
            "license": "25MA024994100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1595008",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edison-Clark Oral Surgery Associates
• Robert Edmonds, ATCL
• Jernier Edwards
• Keisha Edwards, MA, SLPD CCC-SLP
• Morton Eidelberg, RPH
• Linda Ekejindu
• Marina Ekladious
• Faith Ekpo
• Charbel El Samra
• Lama El Zein, M.D

• Colon & Rectal Surgery Physician in Edison, NJ
• Providers in Edison, NJ by specialty
• Colon & Rectal Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.