Individual provider Active NPI

Sophie Anna Greenberg, M.D.

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1609300482
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
310521 Issued in NY
Practice address
30 Central Park S RM 10a
New York, NY 10019-1628
Phone
(646) 907-8664
Fax
(917) 423-6183
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 310521 NY Primary

Addresses

Primary practice location

30 Central Park S RM 10a
New York, NY 10019-1628

Mailing address

PO Box 20072
New York, NY 10023-1477
Phone (646) 907-2664

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210714000962 NY Practitioner - Dermatology 6406258425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Columbia University College of Physicians and Surgeons, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 Central Park S
RM 10a
New York, NY 10019-1628
Phone (646) 907-8864

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions18
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
310521NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Derm Specs of PA PLLC Dermatology CurrentSince Feb 25, 2024 Accepting new patients
Sophie a Greenberg MD PLLC Dermatology CurrentSince Jul 18, 2025 Accepting new patients

Locations

1027 46th Ave
Fl 1
Long Island City, NY 11101

30 Central Park S
Rm 10A
New York, NY 10019
Phone (212) 751-0577

Networks

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

Interoperability endpoints

  • Direct secure messaging: agreenberg@directaddress.net

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1609300482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20072",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100231477",
            "telephone_number": "646-907-2664",
            "fax_number": "917-423-6183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CENTRAL PARK S RM 10A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191628",
            "telephone_number": "646-907-8664",
            "fax_number": "917-423-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "SOPHIE",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "310521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.