NPIMap

Individual provider Active NPI

Shoshana Eisenstein, NP-C

  • Family Nurse Practitioner
  • Port Clinton, OH
National Provider Identifier
1861620973
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
COA10763 Issued in OH
Practice address
619 Fulton St
Port Clinton, OH 43452-2069
Phone
(419) 732-2614
NPI assigned
Jun 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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 COA10763 OH Primary

Addresses

Primary practice location

619 Fulton St
Port Clinton, OH 43452-2069

Mailing address

619 Fulton St
Port Clinton, OH 43452
Phone (419) 732-2614

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20091027000433 OH Practitioner - Nurse Practitioner 7416094255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Lakeview WellnessGroup PAC ID 1355780081, 2 clinicians

Practice addresses (Care Compare)

619 Fulton St
Suite 200
Port Clinton, OH 43452-2069
Phone (419) 732-2614

Hospital & facility affiliations

  • Ohioans Home Healthcare, Inc Home health agency, Perrysburg, OH, CCN 368247
  • Magruder Hospital Hospital, Port Clinton, OH, CCN 361314
  • Firelands Regional Medical Center Hospital, Sandusky, OH, CCN 360025
  • Memorial Hospital Hospital, Fremont, OH, CCN 360156

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA10763OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
C.Steele & Associates LLC Family CurrentSince Jan 11, 2015 Accepting new patients
Lakeview Wellness CurrentSince Jan 1, 2024 Accepting new patients
Q2 Health Clinics, LLC Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Integrated Therapy Services LLC Past Accepting new patients

Locations

619 Fulton St
Ste 200
Port Clinton, OH 43452
Phone (419) 732-2614

619 Fulton St
Port Clinton, OH 43452
Phone (419) 732-2614

Organizations & group practices 5

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 8

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1861620973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "43452",
            "telephone_number": "419-732-2614",
            "fax_number": "419-734-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 FULTON ST",
            "city": "PORT CLINTON",
            "state": "OH",
            "postal_code": "434522069",
            "telephone_number": "419-732-2614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENSTEIN",
        "first_name": "SHOSHANA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA10763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Clinton, OH

Sources for this page

Verify at the official NPI Registry.