Individual provider Active NPI

Molly Lorenz Greenbaum

  • Geriatric Physical Therapist
  • Rochester, NY
National Provider Identifier
1467043695
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
843902052 Issued in NY
Practice address
150 Highland Ave
Rochester, NY 14620
Phone
(585) 760-1300
NPI assigned
Jan 31, 2021
Last updated
Jan 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 843902052 NY Primary

Addresses

Primary practice location

150 Highland Ave
Rochester, NY 14620

Mailing address

4 Whittlers RDG
Pittsford, NY 14534-4522
Phone (315) 939-9995

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230202000895 NY Practitioner - Physical Therapist in Private Practice 2567834492 Reassigns benefits to 2 organizations
Practice locations: Pittsford, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
843902052NYMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Rehabilitation LLP CurrentSince Feb 23, 2023 Accepting new patients
Greenbaum Physical Therapy PLLC Geriatrics CurrentSince Jul 17, 2023 Accepting new patients

Locations

500 N Columbus Ave
Mount Vernon, NY 10552
Phone (914) 266-3796

1 Johnsarbor Dr W
Rochester, NY 14620
Phone (585) 532-7214

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1612051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1467043695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WHITTLERS RDG",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145344522",
            "telephone_number": "315-939-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 HIGHLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14620",
            "telephone_number": "585-760-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBAUM",
        "first_name": "MOLLY",
        "middle_name": "LORENZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-31",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NY",
            "license": "843902052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.