Jay David Eisenberg, M.D.

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

MD11800 Issued in OR

Practice address

1010 SW Mitchell St
Portland, OR 97239-2810

Phone

(503) 246-2803

NPI assigned

Jun 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922201938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SW MITCHELL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SW MITCHELL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392810",
            "telephone_number": "503-246-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "JAY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "OR",
            "license": "MD11800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eir LLC
• Kathryn Rae Eischeid, PAC
• David C Eisen, BS, MSW, OMD, LAC
• Glenn Miles Eisen, MD
• Jeffrey Curtis Eisen, MD
• Lauren Eisenberg
• Linda Kathleen Eisenberg, MA MED LPA LPC PSYA
• Todd D Eisenberg, M.D.
• Tricia Lea Eisenbraun, RD, LD
• Sara Eisenfeld, MSW

• Pediatric Pulmonology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Pulmonology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.