Individual provider Active NPI

Marcia Rosemarie Greene, D.M.D.

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1588652432
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
039401 Issued in NY
Practice address
736 Castleton Ave FL 1
Staten Island, NY 10310-1803
Phone
(718) 273-8686
Fax
(718) 273-2851
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 039401 NY Primary

Addresses

Primary practice location

736 Castleton Ave FL 1
Staten Island, NY 10310-1803

Mailing address

736 Castleton Ave FL 1
Staten Island, NY 10310-1803
Phone (718) 273-8686

Other identifiers 1

IdentifierTypeStateIssuer
01007712MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rach Center for Sleep Apnea and Integrave Wellness LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1588652432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 CASTLETON AVE FL 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101803",
            "telephone_number": "718-273-8686",
            "fax_number": "718-273-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 CASTLETON AVE FL 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101803",
            "telephone_number": "718-273-8686",
            "fax_number": "718-273-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "MARCIA",
        "middle_name": "ROSEMARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "039401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01007712",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.