Individual provider Active NPI

Michael E Greenberg, MD

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1649213166
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD019653E Issued in PA
Practice address
230 N Broad St
Drexel Emergency Med Huh
Philadelphia, PA 19102-1121
Phone
(215) 762-7963
Fax
(215) 246-5793
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD019653E PA Primary
Medical Toxicology (Emergency Medicine) Physician 207PT0002X MD019653E PA

Addresses

Primary practice location

230 N Broad St
Drexel Emergency Med Huh
Philadelphia, PA 19102-1121

Mailing address

1601 Cherry St
Suite 11511
Philadelphia, PA 19102-1321
Phone (215) 255-7822

Other identifiers 1

IdentifierTypeStateIssuer
000891368MedicaidPA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD019653EPAMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1649213166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST",
            "address_2": "SUITE 11511",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021321",
            "telephone_number": "215-255-7822",
            "fax_number": "215-255-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "address_2": "DREXEL EMERGENCY MED HUH",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-7963",
            "fax_number": "215-246-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "MICHAEL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD019653E",
            "primary": true
        },
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "PA",
            "license": "MD019653E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000891368",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.