Active NPI
Tina Sue Greenberg, DC
- Acupuncturist
- St Louis Park, MN
National Provider Identifier
1396844916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 632
- Practice address
- 5407 Excelsior Blvd
Suite D
St Louis Park, MN 55416 - Phone
- (952) 920-9247
- Fax
- (952) 922-3480
- NPI assigned
- Sep 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1715 | MN | |
| Chiropractor | 111N00000X | 2045 | OK | |
| Chiropractor | 111N00000X | 1442 | WA | |
| Acupuncturist | 171100000X | 632 | MN | Primary |
Addresses
Primary practice location
5407 Excelsior Blvd
Suite D
St Louis Park, MN 55416
Mailing address
5407 Excelsior Blvd
Suite D
St Louis Park, MN 55416
Phone (952) 920-9247
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4486621 | Other | MN | MEDICA |
| 413616R | Other | MN | B/C B/S |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1715 | MN | MD | Marriage & Family Therapist |
| 1442 | WA | MD | Chiropractor |
| 632 | MN | MD | Acupuncturist |
| 2045 | OK | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Excelsior and Grand Chiropractic | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- St Louis Park, MN
- NPI 1932691714
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1396844916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5407 EXCELSIOR BLVD",
"address_2": "SUITE D",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "55416",
"telephone_number": "952-920-9247",
"fax_number": "952-922-3480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5407 EXCELSIOR BLVD",
"address_2": "SUITE D",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "55416",
"telephone_number": "952-920-9247",
"fax_number": "952-922-3480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBERG",
"first_name": "TINA",
"middle_name": "SUE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-21",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "1715",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OK",
"license": "2045",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WA",
"license": "1442",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MN",
"license": "632",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "4486621",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "B/C B/S",
"identifier": "413616R",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.