Individual provider Active NPI

Michael Herbert Eisman, M.D.

  • Internal Medicine Physician
  • Montour Falls, NY
National Provider Identifier
1639244205
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
131704 Issued in NY
Practice address
220 Steuben St
Montour Falls, NY 14865-9740
Phone
(607) 210-1943
Fax
(607) 210-1940
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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 131704 NY Primary

Addresses

Primary practice location

220 Steuben St
Montour Falls, NY 14865-9740

Mailing address

220 Steuben St
Montour Falls, NY 14865-9740
Phone (607) 210-1943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080128000256 NY Practitioner - Internal Medicine 7113915554 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler Hospital Inc CurrentSince Apr 21, 2009 Accepting new patients
Schuyler Hospital Inc Internal Medicine CurrentSince Apr 21, 2009 Accepting new patients
Hector Falls Integrative Medicine Past Accepting new patients

Locations

3835 State Route 414
Burdett, NY 14818
Phone (607) 546-7193

220 Steuben St
Montour Falls, NY 14865
Phone (607) 535-7121

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1639244205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 STEUBEN ST",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659740",
            "telephone_number": "607-210-1943",
            "fax_number": "607-210-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 STEUBEN ST",
            "city": "MONTOUR FALLS",
            "state": "NY",
            "postal_code": "148659740",
            "telephone_number": "607-210-1943",
            "fax_number": "607-210-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISMAN",
        "first_name": "MICHAEL",
        "middle_name": "HERBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "131704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montour Falls, NY

Sources for this page

Verify at the official NPI Registry.