Individual provider Active NPI

Sheldon Burt Greenberg, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Norwalk, CT
National Provider Identifier
1124115662
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
022559 Issued in CT
Practice address
761 Main Ave Ste 101
Norwalk, CT 06851-1080
Phone
(203) 845-2244
Fax
(203) 845-2249
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 022559 CT Primary
Plastic Surgery Physician 208200000X 022559 CT

Addresses

Primary practice location

761 Main Ave Ste 101
Norwalk, CT 06851-1080

Mailing address

761 Main Ave Ste 101
Norwalk, CT 06851-1080
Phone (203) 845-2244

Other identifiers 1

IdentifierTypeStateIssuer
00125598MedicaidCT

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
022559CTMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1124115662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE STE 101",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-845-2244",
            "fax_number": "203-845-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 MAIN AVE STE 101",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068511080",
            "telephone_number": "203-845-2244",
            "fax_number": "203-845-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "SHELDON",
        "middle_name": "BURT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "CT",
            "license": "022559",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CT",
            "license": "022559",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00125598",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; 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.