Individual provider Active NPI

Russell M. Greif, D.O.

  • Internal Medicine Physician
  • Lancaster, CA
National Provider Identifier
1669519765
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A5410 Issued in CA
Practice address
44241 15TH St W
Suite 206
Lancaster, CA 93534-4037
Phone
(661) 726-6490
Fax
(661) 726-6494
NPI assigned
Jan 30, 2007
Last updated
Dec 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A5410 CA Primary

Addresses

Primary practice location

44241 15TH St W
Suite 206
Lancaster, CA 93534-4037

Mailing address

2010 W Avenue K # 632
Lancaster, CA 93536-5229
Phone (661) 726-6490

Other identifiers 4

IdentifierTypeStateIssuer
020A54100MedicaidCA
954483182OtherCABLUE CROSS
DOAX54100MedicaidCA
020A54100OtherCABLUE SHIELD

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
I20100915000042 CA Practitioner - Internal Medicine 7911022934 Practice locations: Lancaster, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
College of Osteo Med of the Pacific at Pomona, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

44241 15TH St W
Suite 206
Lancaster, CA 93534-5501

44241 15TH W St
Suite 206
Lancaster, CA 93534-5501
Phone (661) 726-6490

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5410CAMDMental Health Counselor
20A5410CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Antelope Valley Health Care District 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1669519765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 W AVENUE K # 632",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935365229",
            "telephone_number": "661-726-6490",
            "fax_number": "661-726-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44241 15TH ST W",
            "address_2": "SUITE 206",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935344037",
            "telephone_number": "661-726-6490",
            "fax_number": "661-726-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREIF",
        "first_name": "RUSSELL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A5410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020A54100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "954483182",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DOAX54100",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "020A54100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

Verify at the official NPI Registry.