NPIMap

Individual provider Active NPI

Adva Tal Eisenberg, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
National Provider Identifier
1760724983
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2017-01300 Issued in NC
Practice address
1918 Randolph Rd Ste 220
Charlotte, NC 28207-1109
Phone
(704) 316-1125
Fax
(704) 316-1143
NPI assigned
Mar 26, 2013
Last updated
Oct 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2017-01300 NC Primary

Addresses

Primary practice location

1918 Randolph Rd Ste 220
Charlotte, NC 28207-1109

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aeisenberg735462@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180907001197 NC Practitioner - EndocrinologyPractitioner - Internal Medicine 9638429947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Emory University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1918 Randolph Rd
Suite 220
Charlotte, NC 28207-1109
Phone (704) 316-1125

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital CurrentSince Apr 24, 2023 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC Endocrinology, Diabetes & Metabolism Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 27, 2019 Accepting new patients
Novant Health Medical Group, LLC Endocrinology, Diabetes & Metabolism CurrentSince Aug 27, 2019 Accepting new patients
The Presbyterian Hospital CurrentSince Apr 24, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1918 Randolph Rd
Ste 220
Charlotte, NC 28207
Phone (704) 316-1125

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

19485 Old Jetton Rd
Ste 270
Cornelius, NC 28031
Phone (704) 384-7700

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: aeisenberg735462@direct.novanthealth.org

Organizations & group practices 8

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.

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1760724983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD STE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071109",
            "telephone_number": "704-316-1125",
            "fax_number": "704-316-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "ADVA",
        "middle_name": "TAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "2017-01300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aeisenberg735462@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1918 Randolph Rd Ste 220",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.