Individual provider Active NPI

Amy L Eisenberg, FNP

  • Family Nurse Practitioner
  • Hauppauge, NY
National Provider Identifier
1639469042
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336613-01 Issued in NY
Practice address
80 Arkay Dr Ste 230
Hauppauge, NY 11788-3705
Phone
(833) 342-1454
NPI assigned
Apr 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336613-01 NY Primary

Addresses

Primary practice location

80 Arkay Dr Ste 230
Hauppauge, NY 11788-3705

Mailing address

80 Arkay Dr Ste 230
Hauppauge, NY 11788-3705
Phone (833) 342-1454

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110608000095 NY Practitioner - Nurse Practitioner 1759568330 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dennis Mihale MD of Ny PCGroup PAC ID 7012325285, 4 clinicians

Practice addresses (Care Compare)

80 Arkay Dr
Hauppauge, NY 11788-3705
Phone (888) 985-5455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
336613NYMDEmergency Medicine Physician
F336613-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis Mihale MD of Ny PC CurrentSince Sep 1, 2022 Accepting new patients
White Plains Medical Diagnostic Services, PC CurrentSince Oct 1, 2022 Accepting new patients

Locations

80 Arkay Dr
Ste 230
Hauppauge, NY 11788
Phone (631) 540-8225

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

275 N Middletown Rd
Ste 1F
Pearl River, NY 10965
Phone (845) 735-6699

97 Route 303
Tappan, NY 10983
Phone (845) 348-2198

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Interoperability endpoints

  • Direct secure messaging: amy.eisenberg.1@15578.direct.athenahealth.com

Organizations & group practices 2

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": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1639469042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ARKAY DR STE 230",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883705",
            "telephone_number": "833-342-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ARKAY DR STE 230",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883705",
            "telephone_number": "833-342-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "AMY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-19",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336613-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

Verify at the official NPI Registry.