Individual provider Active NPI

Peter Greenberg, MD

  • Radiation Oncology Physician
  • Palm Desert, CA
National Provider Identifier
1568552859
Registry record updated Aug 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
G48958 Issued in CA
Practice address
77840 Flora Rd
Palm Desert, CA 92211-4109
Phone
(760) 200-8777
Fax
(760) 200-8877
NPI assigned
Oct 15, 2006
Last updated
Aug 26, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G48958 CA
Radiation Oncology Physician 2085R0001X G48958 CA Primary

Addresses

Primary practice location

77840 Flora Rd
Palm Desert, CA 92211-4109

Mailing address

2234 Colonial Blvd
Managed Care Dept.
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 4

IdentifierTypeStateIssuer
GR0063580MedicaidCA
P00703711OtherCARAILROAD MEDICARE
00G489580OtherCABLUE SHIELD / TRICARE CALI.
4103385OtherCAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050125000604 CA Practitioner - Radiation Oncology 3375593601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of California, Geffen School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Chico Medical Group IncGroup PAC ID 2668807785, 10 clinicians

Practice addresses (Care Compare)

74000 Cnty Club Dr
Palm Desert, CA 92260-1685
Phone (760) 368-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G48958CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Healthcare System, L.P. Past Accepting new patients
Hi-Desert Medical Center Past Accepting new patients
Diagnostic Imaging Services Past Accepting new patients
Compassionate Cancer Care Radiation Diagnostics Group Inc Radiation Oncology Past Accepting new patients
Peter Greenberg, MD Inc PastSince Aug 23, 1996 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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 1

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": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1568552859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "MANAGED CARE DEPT.",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77840 FLORA RD",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922114109",
            "telephone_number": "760-200-8777",
            "fax_number": "760-200-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G48958",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "G48958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0063580",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00703711",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD / TRICARE CALI.",
            "identifier": "00G489580",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4103385",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.