Organization Active NPI

Lawrence Greenberg DO

  • Nephrology Physician
  • Berkley, MI
National Provider Identifier
1285208629
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
LAWRENCE GREENBERG DO
Practice address
2624 11 Mile Rd
Berkley, MI 48072-3050
Phone
(248) 399-0764
NPI assigned
May 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Lawrence Greenberg, DONPI 1568459196
Title
Physician Owner
Phone
(248) 828-7500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

2624 11 Mile Rd
Berkley, MI 48072-3050

Mailing address

PO Box 33738 Dept 999364
Detroit, MI 48232-3738
Phone (248) 933-4409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210727000667 MI Part B Supplier - Clinic/Group Practice 7113320243 Receives reassigned benefits from 1 practitioner
Practice locations: Detroit, MI; Troy, MI; Royal Oak, MI

National Provider Directory

National Provider Directory

Locations

18944 Grand River Ave
Detroit, MI 48223
Phone (313) 837-1530

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1285208629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33738 DEPT 999364",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482323738",
            "telephone_number": "248-933-4409",
            "fax_number": "248-661-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 11 MILE RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723050",
            "telephone_number": "248-399-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE GREENBERG DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "248-828-7500",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.