SAMUEL CASEY EISENBERG
NPI 1336889922
Student in an Organized Health Care Education/Training Program in Manhasset, NY

Q: What is Samuel Eisenberg's NPI number?

The NPI number for Samuel Eisenberg is 1336889922. It was assigned to this individual provider in the NPPES registry on March 31, 2022.

Q: What is Samuel Eisenberg's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Eisenberg was last updated on June 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 31, 2022PECOS Enrolled

300 COMMUNITY DR, MANHASSET, NY 11030(516) 562-4764(516) 562-3555 Get Directions Write a Review

NPPES record last updated: June 4, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 4, 2025, Apr 8, 2022 (2 updates tracked since 2022).

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About Samuel Casey Eisenberg NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL CASEY EISENBERG (NPI 1336889922) is an individual student in an organized health care education/training program in Manhasset, New York and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1336889922

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSAMUEL CASEY EISENBERG

Location Address300 COMMUNITY DRManhasset, NY 11030-3876

Mailing Address6201 Greenleigh AveMiddle River, MD 21220-2004 · (104) 933-2704 · Fax (410) 500-4266

Phone(516) 562-4764

Fax(516) 562-3555

Sole ProprietorNo

Enumeration DateMarch 31, 2022

Last NPPES UpdateJune 4, 20252 updates tracked since enumeration

NPPES CertifiedJune 4, 2025

✔ NPI 1336889922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

300 COMMUNITY DR, Manhasset, NY 11030

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Secondary Practice Locations 2

Location 127005 76th AveNew Hyde Park, NY 11040-1496 · Phone (718) 470-7000

Location 21800 Orleans StBaltimore, MD 21287-0010 · Phone (410) 022-0375 · Fax (410) 955-0737

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Casey Eisenberg is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.