Individual provider Active NPI

Richard Greene, MD

  • Dermatology Physician
  • Highland Park, IL
National Provider Identifier
1205894169
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
163843 Issued in NY
Practice address
1160 Park Ave W Ste 3E
Highland Park, IL 60035-2271
Phone
(847) 926-3109
Fax
(847) 469-4061
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 163843 NY Primary

Addresses

Primary practice location

1160 Park Ave W Ste 3E
Highland Park, IL 60035-2271

Mailing address

1160 Park Ave W Ste 3E
Highland Park, IL 60035-2271
Phone (847) 926-3109

Other practice location 1

2150 S Clinton Ave
Rochester, NY 14618-2618
Phone (585) 256-0555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, IL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20051019000464 NY Practitioner - Dermatology 5991721987
I20250117001449 FL Practitioner - Dermatology 5991721987 Reassigns benefits to 1 organization
I20250924002958 IL Practitioner - Dermatology 5991721987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1160 Park Ave W
Suite 3E
Highland Park, IL 60035-2271
Phone (585) 766-5588

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions94
Removal or shaving of skin growth1-10
Skin biopsy18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
163843NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dazzling Dermatology, PLLC Dermatology CurrentSince Feb 14, 2025 Accepting new patients
McCaw Dermatology SC Dermatology CurrentSince Aug 7, 2025 Accepting new patients
Western New York Dermatology, PLLC Past Accepting new patients

Locations

22029 State Road 7
Ste 101
Boca Raton, FL 33428
Phone (561) 923-0905

1160 Park Ave W
Ste 3E
Highland Park, IL 60035
Phone (585) 766-5588

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, 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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1205894169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 PARK AVE W STE 3E",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352271",
            "telephone_number": "847-926-3109",
            "fax_number": "847-469-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 PARK AVE W STE 3E",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352271",
            "telephone_number": "847-926-3109",
            "fax_number": "847-469-4061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 S Clinton Ave",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146182618",
            "country_code": "US",
            "telephone_number": "585-256-0555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "163843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, IL

Sources for this page

Verify at the official NPI Registry.