Individual provider Active NPI

Mandy Sher Greenberg, M.D.

  • Surgical Oncology Physician
  • Norwalk, CT
National Provider Identifier
1043414436
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
49180 Issued in CT
Practice address
761 Main Ave
Suite 203
Norwalk, CT 06851-1080
Phone
(203) 846-6012
Fax
(203) 846-6014
NPI assigned
Jun 12, 2007
Last updated
Oct 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 49180 CT Primary

Addresses

Primary practice location

761 Main Ave
Suite 203
Norwalk, CT 06851-1080

Mailing address

761 Main Ave
Suite 203
Norwalk, CT 06851-1080
Phone (203) 846-6012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130815000823 CT Practitioner - Surgical Oncology 7214179597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical Oncology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nuvance Health Medical Practice CT IncGroup PAC ID 4789597691, 742 clinicians

Practice addresses (Care Compare)

24 Hospital Ave
Danbury, CT 06810-6099
Phone (203) 739-7118

34 Maple St
Norwalk, CT 06850-3815
Phone (203) 762-5588

761 Main Ave
Norwalk, CT 06851-1080
Phone (203) 403-3490

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49180CTMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice CT, Inc. CurrentSince Nov 17, 2014 Accepting new patients
Norwalk Hospital Association CurrentSince Jan 1, 2016 Accepting new patients
Norwalk Hospital Association CurrentSince Jan 1, 2016 Accepting new patients
Fairfield County Medical Services Inc Past Accepting new patients

Locations

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

38 East Ave
New Canaan, CT 06840
Phone (203) 594-9520

520 West Ave
Norwalk, CT 06850
Phone (203) 852-2417

761 Main Ave
Norwalk, CT 06851
Phone (203) 845-2160

761 Main Ave
Ste 203
Norwalk, CT 06851
Phone (203) 663-1750

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383004800000",
    "number": "1043414436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE",
            "address_2": "SUITE 203",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-846-6012",
            "fax_number": "203-846-6014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE",
            "address_2": "SUITE 203",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-846-6012",
            "fax_number": "203-846-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "MANDY",
        "middle_name": "SHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2013-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CT",
            "license": "49180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.