Organization Active NPI

Greenfield Associates, M.D., P.a.

  • Internal Medicine Physician
  • Annapolis, MD
National Provider Identifier
1396770996
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GREENFIELD ASSOCIATES, M.D., P.A.
Practice address
139 Old Solomons Island Rd
Annapolis, MD 21401-0904
Phone
(410) 224-2222
Fax
(410) 224-4926
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Mrs. Katrina Williams
Title
Office Manager
Phone
(410) 224-4926

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

139 Old Solomons Island Rd
Annapolis, MD 21401-0904

Mailing address

139 Old Solomons Island Rd
Annapolis, MD 21401-0904
Phone (410) 224-2222

Other identifiers 5

IdentifierTypeStateIssuer
081681700MedicaidMD
272251800MedicaidMD
690102600MedicaidMD
772051300MedicaidMD
151451200MedicaidMD

Other names 1

  • Greenfield M.D., and Associates, P.A. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050112000159 MD Part B Supplier - Clinic/Group Practice 4082662416 Receives reassigned benefits from 3 practitioners
Practice locations: Annapolis, MD

National Provider Directory

National Provider Directory

Locations

139 Old Solomons Island Rd
Ste E
Annapolis, MD 21401

139 Old Solomons Island Rd
Ste D
Annapolis, MD 21401
Phone (410) 224-2222

Practitioners & affiliated clinicians

Practitioners 3

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": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1396770996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 OLD SOLOMONS ISLAND RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214010904",
            "telephone_number": "410-224-2222",
            "fax_number": "410-224-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 OLD SOLOMONS ISLAND RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214010904",
            "telephone_number": "410-224-2222",
            "fax_number": "410-224-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENFIELD ASSOCIATES, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-224-4926",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081681700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272251800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690102600",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "772051300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151451200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenfield M.D., and Associates, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.