Active NPI
Steven M. Greenberg, MD
- Family Medicine Physician
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- M-7049
- Practice address
- 1880 Judith Lane
Boise, ID 83705-3185 - Phone
- (208) 367-6910
- Fax
- (208) 367-6140
- NPI assigned
- Mar 30, 2006
- Last updated
- Feb 27, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M7049 | ID | |
| Family Medicine Physician | 207Q00000X | M-7049 | ID | Primary |
Addresses
Primary practice location
1880 Judith Lane
Boise, ID 83705-3185
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8738
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003702400 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Geisel School of Medicine at Dartmouth, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
100 Hospital Dr
Ketchum, ID 83340
100 Hospital Dr
Ketchum, ID 83340-9998
1450 Aviation Dr
Hailey, ID 83333-8785
191 5TH St W
Ketchum, ID 83340-9998
Phone (208) 725-2171
Hospital & facility affiliations
- St Lukes Home Care and Hospice
- Idaho Home Health & Hospice
- St Luke's Wood River Medical Center
- St Lukes Magic Valley Medical Center
- St Luke's Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M-7049 | ID | MD | Family Medicine Physician |
| M7049 | ID | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic - Wood River LLC | Family Medicine | Current | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
1450 Aviation Dr
Ste 100
Hailey, ID 83333
Phone (208) 788-3434
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Ketchum, ID
- NPI 1972891604
Family Medicine
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Lukes Home Care
- Home Health Agency
- Meridian, ID
- NPI 1306945985
-
dba St Lukes Meridian Medical Center
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
dba St Lukes Wood River Medical Center
- Critical Access Hospital
- Ketchum, ID
- NPI 1508869470
-
dba St Lukes Magic Valley - Air Ambulance
- General Acute Care Hospital
- Twin Falls, ID
- NPI 1932154705
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424995200000",
"number": "1407817364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-8738",
"fax_number": "208-367-5180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1880 JUDITH LANE",
"city": "BOISE",
"state": "ID",
"postal_code": "837053185",
"telephone_number": "208-367-6910",
"fax_number": "208-367-6140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBERG",
"first_name": "STEVEN",
"middle_name": "M.",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-30",
"last_updated": "2015-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "M7049",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "M-7049",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003702400",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.