Individual provider Active NPI

Mitchell D Greenberg, PA

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1487642096
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9101088 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 303-5600
NPI assigned
Oct 7, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9101088 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

500 Winderley PL
Suite 115
Maitland, FL 32751-7247
Phone (407) 875-8784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110527000004 FL Practitioner - Physician Assistant 7113104258 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

631 E Altamonte Dr
Suite 231
Altamonte Springs, FL 32701-4802
Phone (407) 303-5214

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.03 of 100Reported as group
Quality
77.92
Promoting interoperability
99
Improvement activities
40
Cost
79.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
The Nemours Foundation CurrentSince Dec 1, 2016 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Mar 1, 2025 Accepting new patients
The Nemours Foundation CurrentSince Dec 1, 2016 Accepting new patients
Rothman Orthopaedics of Florida,PLLC CurrentSince Jul 10, 2023 Accepting new patients
Observation Medicine Specialists LLC Past Accepting new patients
Southeastern Emergency Services P C Medical Past Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

164 NW Madison St
Spc Care
Lake City, FL 32055
Phone (386) 758-1811

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

255 N Lakemont Ave
Winter Park, FL 32792
Phone (407) 647-6070

255 N Lakemont Ave
Ste 207
Winter Park, FL 32792
Phone (407) 852-5333

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mgreenberg62445@direct.nemours.org

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487642096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL",
            "address_2": "SUITE 115",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517247",
            "telephone_number": "407-875-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-303-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "MITCHELL",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9101088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.