Organization Active NPI

Greentree Medical, PLLC

  • Anesthesiology Physician
  • Kingston, NY
National Provider Identifier
1366016677
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
GREENTREE MEDICAL, PLLC
Practice address
301 Hurley Ave
Kingston, NY 12401-2416
Phone
(845) 309-7597
NPI assigned
May 20, 2021
Last updated
May 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Dr. Henry Chen, MDNPI 1629236542
Title
President
Phone
(862) 216-0639

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
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

301 Hurley Ave
Kingston, NY 12401-2416

Mailing address

637 Wyckoff Ave Ste 191
Wyckoff, NJ 07481-1438

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210604000976 NY Part B Supplier - Clinic/Group Practice 6608275045 Receives reassigned benefits from 4 practitioners
Practice locations: Kingston, NY

National Provider Directory

National Provider Directory

Locations

637 Wyckoff Ave
Ste 191
Wyckoff, NJ 07481

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1366016677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 WYCKOFF AVE STE 191",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HURLEY AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124012416",
            "telephone_number": "845-309-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENTREE MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "862-216-0639",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.