Individual provider Active NPI

David Greenblatt, M.D.

  • Radiation Oncology Physician
  • Ridgewood, NJ
National Provider Identifier
1063465490
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
25MA04850800 Issued in NJ
Practice address
223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone
(201) 634-5403
Fax
(201) 634-5765
NPI assigned
May 18, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 25MA04850800 NJ Primary

Addresses

Primary practice location

223 N Van Dien Ave
Ridgewood, NJ 07450-2726

Mailing address

1 Lethbridge PLZ
Route 17 North, Suite #20
Mahwah, NJ 07430-2126
Phone (201) 684-1616

Other identifiers 2

IdentifierTypeStateIssuer
0971804MedicaidNJ
01907657MedicaidNY

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
25MA04850800NJMDRadiation Oncology Physician
194220NYMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Specialty Care PA Radiation Oncology Past Accepting new patients
Metropolitan Specialty Physicians Radiation Oncology Past Accepting new patients
Advanced Radiation Oncology Services of Queens Radiation Oncology PastSince May 12, 2005 Accepting new patients
Premier Radiation Oncology of Nassau, PC Radiation Oncology PastSince Apr 1, 2008 Accepting new patients
Valley Radiation Oncology Assoc PA Radiation Oncology PastSince Feb 24, 1992 Accepting new patients
Bayonne Radiation Oncology Associates, LLC Radiation Oncology Past Accepting new patients
Catskill Radiation Oncology Consultants, PLLC Radiation Oncology PastSince Mar 1, 1998 Accepting new patients

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063465490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LETHBRIDGE PLZ",
            "address_2": "ROUTE 17 NORTH, SUITE #20",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074302126",
            "telephone_number": "201-684-1616",
            "fax_number": "201-684-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N VAN DIEN AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502726",
            "telephone_number": "201-634-5403",
            "fax_number": "201-634-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBLATT",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NJ",
            "license": "25MA04850800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0971804",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01907657",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.