Individual provider Active NPI

Robert S Greenfield, MD

  • Cardiovascular Disease Physician
  • Fountain Valley, CA
National Provider Identifier
1649307000
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
G29135 Issued in CA
Practice address
18111 Brookhurst St # 5100
Fountain Valley, CA 92708-6728
Phone
(714) 546-2238
Fax
(714) 434-8145
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X G29135 CA Primary

Addresses

Primary practice location

18111 Brookhurst St # 5100
Fountain Valley, CA 92708-6728

Mailing address

18111 Brookhurst St # 5100
Fountain Valley, CA 92708-6728
Phone (714) 546-2238

Other identifiers 1

IdentifierTypeStateIssuer
YYY492984YMedicaidCA

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
I20101209000843 CA Practitioner - Cardiovascular Disease (Cardiology) 5991791394 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29135CAMDGeneral Practice Dentistry
G29135CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UC Regents Current Accepting new patients
Pacific Cardiovascular Associates Medical Group, Inc. Past Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

101 The City Dr S
Bldg 25
Orange, CA 92868
Phone (714) 456-5731

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1649307000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST # 5100",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-546-2238",
            "fax_number": "714-434-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 BROOKHURST ST # 5100",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086728",
            "telephone_number": "714-546-2238",
            "fax_number": "714-434-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENFIELD",
        "first_name": "ROBERT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G29135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YYY492984Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.