Individual provider Active NPI

Sandra J Greco, M.D.

  • Obstetrics & Gynecology Physician
  • Long Branch, NJ
National Provider Identifier
1346204153
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA07003900 Issued in NJ
Practice address
279 3Rd Ave
Suite 307
Long Branch, NJ 07740-6205
Phone
(732) 571-0972
Fax
(732) 571-0748
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA07003900 NJ Primary

Addresses

Primary practice location

279 3Rd Ave
Suite 307
Long Branch, NJ 07740-6205

Mailing address

279 3Rd Ave
Suite 307
Long Branch, NJ 07740-6205
Phone (732) 571-0972

Other identifiers 1

IdentifierTypeStateIssuer
8808007MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220518000181 CA Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 0345239315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York Medical College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

4753 W Shaw Ave
Suite 101
Fresno, CA 93722-6209
Phone (559) 277-8738

7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Feb 10, 2022 Accepting new patients
Permanente Medical Group Inc Obstetrics & Gynecology CurrentSince Feb 10, 2022 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

2071 Herndon Ave
Clovis, CA 93611
Phone (559) 324-5000

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

1800 Harrison St
Fl 7
Oakland, CA 94612

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 2

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1346204153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 3RD AVE",
            "address_2": "SUITE 307",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406205",
            "telephone_number": "732-571-0972",
            "fax_number": "732-571-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 3RD AVE",
            "address_2": "SUITE 307",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406205",
            "telephone_number": "732-571-0972",
            "fax_number": "732-571-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRECO",
        "first_name": "SANDRA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA07003900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8808007",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2071 Herndon Ave",
            "city": "Clovis",
            "state": "CA",
            "country_code": "US",
            "postal_code": "936116101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

Verify at the official NPI Registry.