Individual provider Active NPI

Saul Eisenstat, MD

  • Surgery Physician
  • Mountain View, CA
National Provider Identifier
1962464776
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G18507 Issued in CA
Practice address
2204 Grant Rd
Ste 203
Mountain View, CA 94040-3877
Phone
(650) 964-0600
Fax
(650) 964-0991
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G18507 CA Primary
Surgical Oncology Physician 2086X0206X G18507 CA

Addresses

Primary practice location

2204 Grant Rd
Ste 203
Mountain View, CA 94040-3877

Mailing address

2204 Grant Rd
Ste 203
Mountain View, CA 94040-3877
Phone (650) 964-0600

Other identifiers 1

IdentifierTypeStateIssuer
00G185070MedicaidCA

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

State licenses

LicenseStateTypeSpecialty
18507CAMDPsychologist
G18507CAMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midpeninsula Surgical Associates Medical Group Surgery PastSince Oct 6, 2005 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1962464776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 GRANT RD",
            "address_2": "STE 203",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940403877",
            "telephone_number": "650-964-0600",
            "fax_number": "650-964-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 GRANT RD",
            "address_2": "STE 203",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940403877",
            "telephone_number": "650-964-0600",
            "fax_number": "650-964-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENSTAT",
        "first_name": "SAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G18507",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CA",
            "license": "G18507",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G185070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.