Individual provider Active NPI

Debra Ellen Eisner, D.P.M

  • Podiatrist
  • Haverhill, MA
National Provider Identifier
1841382595
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1583 Issued in MA
Practice address
62 Brown St Ste 501
Haverhill, MA 01830-6790
Phone
(978) 372-3201
Fax
(978) 372-3301
NPI assigned
Sep 29, 2006
Last updated
Oct 25, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1583 MA Primary

Addresses

Primary practice location

62 Brown St Ste 501
Haverhill, MA 01830-6790

Mailing address

62 Brown St Ste 501
Haverhill, MA 01830-6790
Phone (978) 372-3201

Other identifiers 2

IdentifierTypeStateIssuer
Y70672OtherBLUE CROSS
713925OtherTUFTS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20060411000343 MA Practitioner - Podiatry 6305855867 Reassigns benefits to 1 organization
Practice locations: Haverhill, MA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Merrimack Valley Foot Specialists IncGroup PAC ID 4587796883, 2 clinicians

Practice addresses (Care Compare)

62 Brown St
Suite 203
Haverhill, MA 01830-6790
Phone (978) 556-9700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue292
Removal or shaving of skin growth199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1583MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Merrimack Valley Foot Specialists, Inc Podiatrist CurrentSince Apr 1, 2020 Accepting new patients

Locations

62 Brown St
Ste 203
Haverhill, MA 01830
Phone (617) 567-2111

Interoperability endpoints

  • Direct secure messaging: debra.eisner@mvfsi-ma.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1841382595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 BROWN ST STE 501",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306790",
            "telephone_number": "978-372-3201",
            "fax_number": "978-372-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 BROWN ST STE 501",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306790",
            "telephone_number": "978-372-3201",
            "fax_number": "978-372-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISNER",
        "first_name": "DEBRA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "Y70672",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "713925",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.