Individual provider Active NPI

Allan Mitchel Greissman, M.D

  • Pediatric Critical Care Medicine Physician
  • Hollywood, FL
National Provider Identifier
1093800740
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME0065578 Issued in FL
Practice address
3501 Johnson St
Division of Pediatric Critical Care
Hollywood, FL 33021-5421
Phone
(954) 265-6301
Fax
(954) 985-1434
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X ME0065578 FL Primary

Addresses

Primary practice location

3501 Johnson St
Division of Pediatric Critical Care
Hollywood, FL 33021-5421

Mailing address

1117 E Hallandale Beach Blvd
Hallandale, FL 33009
Phone (954) 457-8771

Other identifiers 1

IdentifierTypeStateIssuer
251257200MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agreissman13230@MHSDIRECT.NET

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160824000712 FL Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 2466747811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pediatric Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Critical Care of S FL PAGroup PAC ID 0749535789, 2 clinicians

Practice addresses (Care Compare)

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-6301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0065578FLMDPediatric Critical Care Medicine Physician

Interoperability endpoints

  • Direct secure messaging: agreissman13230@mhsdirect.net

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1093800740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E HALLANDALE BEACH BLVD",
            "city": "HALLANDALE",
            "state": "FL",
            "postal_code": "33009",
            "telephone_number": "954-457-8771",
            "fax_number": "954-266-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "address_2": "DIVISION OF PEDIATRIC CRITICAL CARE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-265-6301",
            "fax_number": "954-985-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREISSMAN",
        "first_name": "ALLAN",
        "middle_name": "MITCHEL",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME0065578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251257200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agreissman13230@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "3501 Johnson St",
            "address_2": "Division of Pediatric Critical Care",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.