NPIMap

Individual provider Active NPI

Joseph Judah Greenberg, M.D.

  • Internal Medicine Physician
  • St Louis Park, MN
National Provider Identifier
1114169356
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
51921 Issued in MN
Practice address
5115 Excelsior Blvd Ste 712
St Louis Park, MN 55416-2906
Phone
(702) 964-1525
NPI assigned
Apr 2, 2009
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 51921 MN Primary
General Practice Physician 208D00000X 51921 MN

Addresses

Primary practice location

5115 Excelsior Blvd Ste 712
St Louis Park, MN 55416-2906

Mailing address

5115 Excelsior Blvd Ste 712
St Louis Park, MN 55416-2906

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100715000439 MN Practitioner - General Practice 7012049794 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51921MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aeris Medical Group PLLC Multi-Specialty CurrentSince Jan 1, 2021 Accepting new patients
Moments Palliative Care LLC Multi-Specialty CurrentSince Jan 27, 2023 Accepting new patients
Healtheast Medical Research Institute Multi-Specialty Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jun 1, 2010 Accepting new patients
Moments Palliative Care LLC Multi-Specialty CurrentSince Jan 27, 2023 Accepting new patients
Villas at Richfield LLC Past Accepting new patients
Estates at Delano LLC Past Accepting new patients
Villas at Brookview LLC Past Accepting new patients
Estates at Chateau LLC Past Accepting new patients
Parmly on the Lake LLC Past Accepting new patients
The Terrace at Crystal LLC Past Accepting new patients
L & R Investments Inc Past Accepting new patients

Locations

820 Lilac Dr N
Ste 210
Minneapolis, MN 55422
Phone (612) 655-5242

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

5115 Excelsior Blvd
St Louis Park, MN 55416
Phone (612) 920-5351

Ownership & related parties

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Crest View Lutheran HomeColumbia Heights, MN, CCN 245018 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2026
Mar 12, 2026
Maplewood Rehabilitation Center LLCMaplewood, MN, CCN 245276 Skilled nursing facility Contracted Managing Employee (5%) Dec 31, 2023
Moments Hospice of Rochester LLCRochester, MN, CCN 241607 Hospice W-2 Managing Employee Jul 1, 2024
Moments HospiceHermantown, MN, CCN 241609 Hospice Contracted Managing Employee Aug 1, 2025
Moments Hospice of MilwaukeeMt Pleasant, WI, CCN 521605 Hospice Contracted Managing Employee Mar 30, 2026
Moments HospiceMadison, WI, CCN 521607 Hospice Contracted Managing Employee Aug 1, 2025
Moments Hospice of Appleton LLCAppleton, WI, CCN 521606 Hospice W-2 Managing Employee May 1, 2024
Moments Hospice of Green Bay LLCGreen Bay, WI, CCN 521619 Hospice Contracted Managing Employee Jul 1, 2024
Moments Hospice of Mankato LLCMankato, MN, CCN 241616 Hospice W-2 Managing Employee Jan 4, 2024
Moments Hospice of Sheboygan LLCSheboygan, WI, CCN 521623 Hospice Contracted Managing Employee Sep 30, 2025
Moments Hospice of Alexandria LLCAlexandria, MN, CCN 241628 Hospice Contracted Managing Employee Mar 1, 2024

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 12

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": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1114169356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 EXCELSIOR BLVD STE 712",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 EXCELSIOR BLVD STE 712",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162906",
            "telephone_number": "702-964-1525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "JOSEPH",
        "middle_name": "JUDAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-02",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "51921",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MN",
            "license": "51921",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.