Individual provider Active NPI

Justine E Greenberg, RPA-C

  • Physician Assistant
  • Deer Park, NY
National Provider Identifier
1245568146
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
013371 Issued in NY
Practice address
2090 Deer Park Ave
Family Medical Care of Babylon
Deer Park, NY 11729-2129
Phone
(631) 667-9440
Fax
(631) 667-3018
NPI assigned
Dec 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 013371 NY Primary

Addresses

Primary practice location

2090 Deer Park Ave
Family Medical Care of Babylon
Deer Park, NY 11729-2129

Mailing address

2090 Deer Park Ave
Family Medical Care of Babylon
Deer Park, NY 11729-2129
Phone (631) 667-9440

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119001266 NY Practitioner - Physician Assistant 7719166990 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
013371NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc. CurrentSince Sep 23, 2019 Accepting new patients
Sun River Health Inc CurrentSince Sep 23, 2019 Accepting new patients
Island Medical House Doctor PC PastSince Feb 5, 2009 Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

6 Henry St
Beacon, NY 12508
Phone (845) 831-0400

1869 Brentwood Rd
Brentwood, NY 11717
Phone (631) 416-5480

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: justine.greenberg@hrh.eclinicaldirectplus.com

Organizations & group practices 5

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": "1259798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1245568146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 DEER PARK AVE",
            "address_2": "FAMILY MEDICAL CARE OF BABYLON",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292129",
            "telephone_number": "631-667-9440",
            "fax_number": "631-667-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 DEER PARK AVE",
            "address_2": "FAMILY MEDICAL CARE OF BABYLON",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292129",
            "telephone_number": "631-667-9440",
            "fax_number": "631-667-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "JUSTINE",
        "middle_name": "E",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-03",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, NY

Sources for this page

Verify at the official NPI Registry.