Individual provider Active NPI

Robert Greenberger, LCSW

  • Clinical Social Worker
  • Melville, NY
National Provider Identifier
1225598915
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
073261-1 Issued in NY
Practice address
445 Broadhollow Rd Ste 25
Melville, NY 11747-3645
Phone
(516) 873-8056
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 073261-1 NY Primary

Addresses

Primary practice location

445 Broadhollow Rd Ste 25
Melville, NY 11747-3645

Mailing address

16 Foothill LN
Smithtown, NY 11787-2348
Phone (631) 766-1210

Other practice location 1

16 Foothill Ln
Smithtown, NY 11787-2348
Phone (631) 766-1210

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
073261-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Keybridge Systems, LLC Clinical PastSince Jul 28, 2019 Accepting new patients

Organizations & group practices 1

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1225598915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 FOOTHILL LN",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872348",
            "telephone_number": "631-766-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 BROADHOLLOW RD STE 25",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473645",
            "telephone_number": "516-873-8056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Foothill Ln",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117872348",
            "country_code": "US",
            "telephone_number": "631-766-1210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENBERGER",
        "first_name": "ROBERT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073261-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.