Individual provider Active NPI

Robert Mark Eisdorfer, MD

  • Gastroenterology Physician
  • Rockville, MD
National Provider Identifier
1891789046
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
D0041731 Issued in MD
Practice address
14955 Shady Grove Rd
Suite 150
Rockville, MD 20850-8700
Phone
(301) 340-3252
Fax
(301) 340-1423
NPI assigned
Sep 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X D0041731 MD Primary

Addresses

Primary practice location

14955 Shady Grove Rd
Suite 150
Rockville, MD 20850-8700

Mailing address

14955 Shady Grove Rd
Suite 150
Rockville, MD 20850-8700
Phone (301) 340-3252

Other identifiers 2

IdentifierTypeStateIssuer
597761400MedicaidMD
100005281OtherMDRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
David a. Morowitz Gastroenterology Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1891789046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14955 SHADY GROVE RD",
            "address_2": "SUITE 150",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208508700",
            "telephone_number": "301-340-3252",
            "fax_number": "301-340-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14955 SHADY GROVE RD",
            "address_2": "SUITE 150",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208508700",
            "telephone_number": "301-340-3252",
            "fax_number": "301-340-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISDORFER",
        "first_name": "ROBERT",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D0041731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "597761400",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100005281",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.