Evan R Eisenberg, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

236718 Issued in NY

Practice address

4100 Duff PL
Suite a
Seaford, NY 11783-1324

Phone

(516) 520-8080

Fax

(516) 520-8877

NPI assigned

Jul 11, 2006

Last updated

Apr 7, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Urology

Education

State University of New York Downstate Medical Center, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Integrated Medical Professionals PLLCGroup PAC ID 6406868462, 91 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.57 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Cost

75.22

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: evaneisenberg@imppllc.allscriptsdirect.net

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.

• Integrated Medical Professionals PLLC

  • Urology Physician
  • Lake Success, NY
  • NPI 1346203536
  Medicare reassignment Care Compare group NPD
• Hudson Valley Lithotripsy Associates, P.C.

  • Urology Physician
  • Hartsdale, NY
  • NPI 1437242781
  Medicare reassignment NPD
• Integrated Medical Professionals PLLC

  dba Advanced Urology Centers of Ny - Manhattan

  • Durable Medical Equipment & Medical Supplies
  • New York, NY
  • NPI 1295534626

  Urology

  NPD
• Integrated Medical Professionals PLLC

  • Non-Pharmacy Dispensing Site
  • New Hyde Park, NY
  • NPI 1073918009
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1750315883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 BROADHOLLOW ROAD",
            "address_2": "SUITE 142",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "516-931-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 DUFF PL",
            "address_2": "SUITE A",
            "city": "SEAFORD",
            "state": "NY",
            "postal_code": "117831324",
            "telephone_number": "516-520-8080",
            "fax_number": "516-520-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "EVAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "236718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Michele Durkin, MA, CCC-SLP
• Stephanie Michelle Duryea
• Shelley Eckstein, L.C.S.W.-R
• Edward Fryman DPM
• Edward Fryman DPM PLLC
• Jeffrey Neal Elfenbein, D.O.
• Ashley Ellis, MS, PA-C
• Maria Alaina Esposito-Pickering, PSY.D.
• Karen Exposito, MS CCC SLP
• Carol Fagan

• Urology Physician in Seaford, NY
• Providers in Seaford, NY by specialty
• Urology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.