Individual provider Active NPI

Ronald Greenberg, MD

  • Internal Medicine Physician
  • North Babylon, NY
National Provider Identifier
1164478996
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
137543 Issued in NY
Practice address
300 Bay Shore Rd
North Babylon, NY 11703-2823
Phone
(631) 586-2700
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 137543 NY Primary

Addresses

Primary practice location

300 Bay Shore Rd
North Babylon, NY 11703-2823

Mailing address

55 Water St FL 12
New York, NY 10041-0004
Phone (646) 680-2888

Other practice location 1

350 S Broadway
Hicksville, NY 11801-5006
Phone (516) 938-0100

Other identifiers 1

IdentifierTypeStateIssuer
01297314MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110207000858 NY Practitioner - Internal Medicine 9133309248 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantagecare Physicians PC CurrentSince Jan 1, 2017 Accepting new patients
Advantagecare Physicians PC Internal Medicine CurrentSince Jan 1, 2017 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

350 S Broadway
Hicksville, NY 11801
Phone (516) 733-8085

441 9th Ave
New York, NY 10001
Phone (646) 680-1595

300 Bay Shore Rd
North Babylon, NY 11703
Phone (631) 586-2700

640 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 737-0100

Interoperability endpoints

  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

Organizations & group practices 3

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1164478996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 12",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BAY SHORE RD",
            "city": "NORTH BABYLON",
            "state": "NY",
            "postal_code": "117032823",
            "telephone_number": "631-586-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Hicksville",
            "state": "NY",
            "postal_code": "118015006",
            "country_code": "US",
            "telephone_number": "516-938-0100",
            "fax_number": "516-938-0120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "RONALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "137543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01297314",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Babylon, NY

Sources for this page

Verify at the official NPI Registry.