Individual provider Active NPI

Raymond Greene

  • Surgical Physician Assistant
  • Mineola, NY
National Provider Identifier
1073733184
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
007679-1 Issued in NY
Practice address
259 1St St
Winthrop University Hospital GP4
Mineola, NY 11501-3957
Phone
(516) 663-2384
Fax
(516) 663-8288
NPI assigned
Apr 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 007679-1 NY Primary

Addresses

Primary practice location

259 1St St
Winthrop University Hospital GP4
Mineola, NY 11501-3957

Mailing address

259 1St St
Winthrop University Hospital GP4
Mineola, NY 11501-3957
Phone (516) 663-2384

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rgreene286534@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070702000618 NY Practitioner - Physician Assistant 1658471768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007679NYMDAcupuncturist
007679-1NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients

Locations

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

259 1st St
#4
Mineola, NY 11501
Phone (516) 663-2384

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: rgreene286534@nyumc.direct-ci.com

Organizations & group practices 2

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.

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": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1073733184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "address_2": "WINTHROP UNIVERSITY HOSPITAL GP4",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-2384",
            "fax_number": "516-663-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 1ST ST",
            "address_2": "WINTHROP UNIVERSITY HOSPITAL GP4",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013957",
            "telephone_number": "516-663-2384",
            "fax_number": "516-663-8288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "RAYMOND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-30",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "007679-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgreene286534@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "259 1st St",
            "address_2": "Winthrop University Hospital GP4",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013957",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.