Peter Tebet Greenspan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

44159 Issued in MA

Practice address

40 2ND Ave
Mass General West Medical Group Ste 400
Waltham, MA 02451-1137

Phone

(781) 487-4340

Fax

(781) 487-4341

NPI assigned

Oct 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Massachusetts General Physicians Organization Inc

  • Dermatology Physician
  • Boston, MA
  • NPI 1801874573

  Pediatrics

  Medicare reassignment NPD
• The General Hospital Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1023049236
  Medicare reassignment NPD

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1295725885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "address_2": "MASS GENERAL PHYSICIAN ORGANIZATION",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142",
            "telephone_number": "781-487-4340",
            "fax_number": "781-487-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 2ND AVE",
            "address_2": "MASS GENERAL WEST MEDICAL GROUP STE 400",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511137",
            "telephone_number": "781-487-4340",
            "fax_number": "781-487-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENSPAN",
        "first_name": "PETER",
        "middle_name": "TEBET",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "44159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "B51049",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "044159",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6164595",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greater Waltham Arc, Inc.
• Greater Waltham Association for Retarded Citizens, Inc.
• Ashley Greco
• Frances Ellen Green, LICSW
• James Mark Greenblatt, M.D
• Phyllis Roslyn Greenspan, MSW
• Erwin Greenstein
• Michael F Griffin, MSPT
• Colin Robert Griffiths, LCSW
• Tyler Grinley, LMHC

• Pediatrics Physician in Waltham, MA
• Providers in Waltham, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.