NPIMap

Individual provider Active NPI

Ethan Greenberg, MD

  • Ophthalmology Physician
  • Fridley, MN
National Provider Identifier
1225416944
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
65460 Issued in MN
Practice address
6341 University Ave NE
Fridley, MN 55432-4946
Phone
(612) 626-5775
NPI assigned
May 14, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 65460 MN Primary

Addresses

Primary practice location

6341 University Ave NE
Fridley, MN 55432-4946

Mailing address

2000 23Rd St S
Sartell, MN 56377-4765
Phone (320) 229-5120

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
I20190627000967 MN Practitioner - Ophthalmology 1759667561 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Temple University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians
Fairview Specialty ServicesGroup PAC ID 3072083286, 303 clinicians
University of Minnesota PhysiciansGroup PAC ID 9830001189, 158 clinicians

Practice addresses (Care Compare)

10000 Zane Ave N
Brooklyn Park, MN 55443-1400
Phone (763) 572-5700

14500 99TH Ave N
Maple Grove, MN 55369-4730
Phone (612) 273-6228

14500 99TH Ave N
Suite 100
Maple Grove, MN 55369-4738
Phone (763) 898-1000

1700 University Ave W
Saint Paul, MN 55104-3727
Phone (855) 324-7843

2450 Riverside Ave
Minneapolis, MN 55454-1450

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

720 Washington Ave SE
Minneapolis, MN 55414-2924
Phone (612) 884-0649

909 Fulton St SE
Minneapolis, MN 55455-4800
Phone (612) 672-7422

Hospital & facility affiliations

  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
67.02
Promoting interoperability
99
Improvement activities
40
Cost
73.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery103

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Mar 14, 2022 Accepting new patients
University of Minnesota Health Clinics and Surgery Center, Inc. Current Accepting new patients
Fairview Express Care CurrentSince Mar 14, 2022 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Clinics CurrentSince Mar 14, 2022 Accepting new patients
University of Minnesota Physicians CurrentSince Mar 14, 2022 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Clinics CurrentSince Mar 14, 2022 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Health Services CurrentSince Mar 14, 2022 Accepting new patients
Fairview Express Care CurrentSince Mar 14, 2022 Accepting new patients
Fairview Clinics Current Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

14500 99th Ave N
Maple Grove, MN 55369
Phone (763) 898-1000

14500 99th Ave N
Ste 100
Maple Grove, MN 55369
Phone (763) 898-1000

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

Interoperability endpoints

  • Direct secure messaging: egreenberg319961@fairview.direct-ci.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1225416944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 23RD ST S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774765",
            "telephone_number": "320-229-5120",
            "fax_number": "320-200-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6341 UNIVERSITY AVE NE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324946",
            "telephone_number": "612-626-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "ETHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-14",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "65460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.