Individual provider Active NPI

Michael L Greenberg, MD

  • Emergency Medicine Physician
  • Forest Hills, NY
National Provider Identifier
1265479976
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
214334 Issued in NY
Practice address
11115 Queens Blvd
FL 2
Forest Hills, NY 11375-7479
Phone
(718) 544-6448
Fax
(718) 544-7719
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 214334 NY
Emergency Medicine Physician 207P00000X 214334 NY Primary

Addresses

Primary practice location

11115 Queens Blvd
FL 2
Forest Hills, NY 11375-7479

Mailing address

11115 Queens Blvd
FL 2
Forest Hills, NY 11375-7479
Phone (718) 544-6448

Other identifiers 1

IdentifierTypeStateIssuer
01950889MedicaidNY

Other names 1

  • Mikhail L Grinberg Former name

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
I20041021000558 NY Practitioner - Internal MedicinePractitioner - HematologyPractitioner - Emergency Medicine 3577524719 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.59 of 100Reported as group
Quality
78.3
Promoting interoperability
100
Improvement activities
40
Cost
72.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214334NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Hill Emergency Physician Services Emergency Medicine CurrentSince Mar 1, 2016 Accepting new patients
Delaware River Medicine, PLLC Emergency Medicine CurrentSince Dec 11, 2020 Accepting new patients
United Medical Associates, P.C. CurrentSince Dec 26, 2016 Accepting new patients
Emergency Physician Services of New York, P.C. Emergency Medicine CurrentSince Dec 1, 2011 Accepting new patients
United Medical Associates PC CurrentSince Dec 26, 2016 Accepting new patients
Exigence Medical of Binghamton PLLC CurrentSince Nov 1, 2014 Accepting new patients
Nuclear Cardiac and Medical Imaging Services, PC Past Accepting new patients
Brookdale Hospital Medical Center Past Accepting new patients
TJH Medical Services, P.C. Internal Medicine Past Accepting new patients
Michael Z Weiner MDPC Past Accepting new patients
MLG Medical , P.C. Past Accepting new patients

Locations

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

160 E Main St
Port Jervis, NY 12771
Phone (845) 856-7000

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

15 Maple Ave
Warwick, NY 10990
Phone (845) 986-2224

127 S Broadway
Yonkers, NY 10701
Phone (914) 378-7342

Organizations & group practices 11

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1265479976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11115 QUEENS BLVD",
            "address_2": "FL 2",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757479",
            "telephone_number": "718-544-6448",
            "fax_number": "718-544-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11115 QUEENS BLVD",
            "address_2": "FL 2",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757479",
            "telephone_number": "718-544-6448",
            "fax_number": "718-544-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "214334",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "214334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01950889",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKHAIL",
            "last_name": "GRINBERG",
            "middle_name": "L",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.