Seth Benjamin Greenberg

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

061436 Issued in NY

Practice address

411 Barnum Avenue Cutoff Ste 5
Stratford, CT 06614-5100

Phone

(203) 690-1960

NPI assigned

Jul 10, 2014

Last updated

Dec 14, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: sgreenberg51460@northwell.direct-ci.com
• Direct secure messaging: sgreenberg845900@nychhc.direct-ci.com

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.

• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty practice Group

  • Orthopaedic Surgery Physician
  • Elmhurst, NY
  • NPI 1609120674
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Mount Sinai Elmhurst Faculty Practice Group

  • Diagnostic Radiology Physician
  • Elmhurst, NY
  • NPI 1619221686
  NPD
• Premier Oral Surgery and Implantology Center LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Stratford, CT
  • NPI 1952898025
  NPD (past)

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1588070452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PARKWAY SOUTH",
            "address_2": "JACOBI MEDICAL CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611119",
            "telephone_number": "718-918-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BARNUM AVENUE CUTOFF STE 5",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066145100",
            "telephone_number": "203-690-1960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Pelham Parkway South",
            "address_2": "Jacobi Medical Center",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104611119",
            "country_code": "US",
            "telephone_number": "718-918-3230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "SETH",
        "middle_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-10",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "12418",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "061436",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shadae Granston, RN
• Dorothy Bonnitto Grant-Lewis
• Janis Grant, COTA/L
• Rashanee Green-Younger, LCSW
• Michael George Green, LADC
• Kristy Gretzula, DDS
• Heather Marie Grew
• Alyson Marie Grimes, MSPT
• Grindels Beautiful You LLC
• Grover Opticians

• Oral and Maxillofacial Surgery (Dentist) in Stratford, CT
• Providers in Stratford, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.