Individual provider Active NPI

Laura J Eisenberg, RN, MN, FNP

  • Pediatric Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1962423095
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP30004206 Issued in WA
Practice address
4800 Sand Point Way NE
6D-1
Seattle, WA 98105-3901
Phone
(206) 987-1941
Fax
(206) 987-3946
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP30004206 WA Primary

Addresses

Primary practice location

4800 Sand Point Way NE
6D-1
Seattle, WA 98105-3901

Mailing address

12509 42ND Ave NE
Seattle, WA 98125-4620
Phone (206) 987-1941

Other identifiers 2

IdentifierTypeStateIssuer
NP988WAMedicaidAK
9627928MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100825000849 WA Practitioner - Nurse Practitioner 0446374607 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP30004206WAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Childrens Hospital CurrentSince Jun 2, 2010 Accepting new patients
Seattle Children'S Hospital CurrentSince Jun 2, 2010 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
#6D1
Seattle, WA 98105
Phone (206) 987-1941

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Interoperability endpoints

  • Direct secure messaging: leisenberg708@direct.seattlechildrens.org

Organizations & group practices 3

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": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962423095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12509 42ND AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254620",
            "telephone_number": "206-987-1941",
            "fax_number": "206-987-3946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "address_2": "6D-1",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-1941",
            "fax_number": "206-987-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "LAURA",
        "middle_name": "J",
        "credential": "RN, MN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP30004206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP988WA",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9627928",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.