Paul David Greenblatt, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

143934 Issued in NY

Practice address

1855 Union Blvd
Bay Shore, NY 11706-7949

Phone

(631) 665-3666

NPI assigned

Sep 30, 2005

Last updated

Feb 1, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PDG Medical PC

  • Internal Medicine Physician
  • Bay Shore, NY
  • NPI 1578712295
  NPD (past) Authorized official
• Joseph Tamburrino

  • Foot & Ankle Surgery Podiatrist
  • Bay Shore, NY
  • NPI 1851575559
  NPD (past)

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1336136787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5390",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117060279",
            "telephone_number": "631-665-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067949",
            "telephone_number": "631-665-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBLATT",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "143934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00705528",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Richard Gray, PA
• Great South Bay Otolaryngology PC (Gargano Bonafede Campbell ODonnell Bergson)
• Jamie Green
• Maria P Green, COTA
• Marie Green, RN
• Donna Greenidge
• Greenland Physical Therapy PC
• Gregory Alexander, PH.D. Psychologist, PC
• Jessica Danielle Gregory, CRNA, RN, BSN, MSN
• Mary Elizabeth Gregory

• Specialist in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.