Organization Active NPI

Scott Greenbaum MD PC

  • Ophthalmology Physician
  • Forest Hills, NY
National Provider Identifier
1104334119
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SCOTT GREENBAUM MD PC
Practice address
6860 Austin St Ste 301a
Forest Hills, NY 11375-4245
Phone
(718) 897-2020
Fax
(718) 897-9514
NPI assigned
Jan 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Scott Greenbaum, MDNPI 1982615639
Title
President
Phone
(718) 897-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

6860 Austin St Ste 301a
Forest Hills, NY 11375-4245

Mailing address

6860 Austin St Ste 301a
Forest Hills, NY 11375-4245
Phone (718) 897-2020

Other practice location 1

77 Park Ave
New York, NY 10016-2556
Phone (212) 686-6075

National Provider Directory

National Provider Directory

Locations

6860 Austin St
Ste 301A
Forest Hills, NY 11375
Phone (718) 897-2020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1104334119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6860 AUSTIN ST STE 301A",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754245",
            "telephone_number": "718-897-2020",
            "fax_number": "718-897-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6860 AUSTIN ST STE 301A",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754245",
            "telephone_number": "718-897-2020",
            "fax_number": "718-897-9514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Park Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100162556",
            "country_code": "US",
            "telephone_number": "212-686-6075",
            "fax_number": "718-897-9514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SCOTT GREENBAUM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "GREENBAUM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-897-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.