Individual provider Active NPI

Sidney Bernard Eisig, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
National Provider Identifier
1710044904
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
036028 Issued in NY
Practice address
630 W 168TH St
Suite VC7-226
New York, NY 10032-3725
Phone
(212) 305-4552
Fax
(212) 305-9649
NPI assigned
Jan 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 036028 NY Primary

Addresses

Primary practice location

630 W 168TH St
Suite VC7-226
New York, NY 10032-3725

Mailing address

180 Fort Washington Ave
Suite HP8-802
New York, NY 10032-3735
Phone (212) 305-8516

Other identifiers 11

IdentifierTypeStateIssuer
4309559OtherNYAETNA PPO
45913POtherNYHIP MEDICAID
036028N02OtherNYHIP
D48781OtherNYEMPIRE BCBS
GS361OtherNYOXFORD
683721OtherNYUNITED HEALTHCARE
0348187OtherNYCIGNA
2635591OtherNYAETNA HMO
1300099OtherNYGHI
4C1608OtherNYHEALTHNET PHS
00964356MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040427001725 NY Practitioner - Oral Surgery 5698762045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
New York University College of Dentistry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, 2,262 clinicians

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
036028NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Jan 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jan 1, 2018 Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
Trustees of Columbia University in the Department of Otolaryngology Past Accepting new patients

Locations

630 W 168th St
#7226
New York, NY 10032
Phone (212) 305-8516

630 W 168th St
Ste VC7226
New York, NY 10032
Phone (212) 305-4552

180 Fort Washington Ave
Ste HP8802
New York, NY 10032

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

51 W 51st St
Ste 350
New York, NY 10019
Phone (212) 305-4599

622 W 168th St
Fl 3
New York, NY 10032
Phone (953) 521-2305

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

630 W 168th St
#20
New York, NY 10032
Phone (212) 305-2015

630 W 168th St
New York, NY 10032
Phone (212) 305-1948

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710044904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 FORT WASHINGTON AVE",
            "address_2": "SUITE HP8-802",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323735",
            "telephone_number": "212-305-8516",
            "fax_number": "212-305-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST",
            "address_2": "SUITE VC7-226",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-4552",
            "fax_number": "212-305-9649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISIG",
        "first_name": "SIDNEY",
        "middle_name": "BERNARD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "036028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4309559",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP MEDICAID",
            "identifier": "45913P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "036028N02",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "D48781",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "GS361",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "683721",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0348187",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2635591",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "1300099",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET PHS",
            "identifier": "4C1608",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00964356",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.