Individual provider Active NPI

Eric Daniel Greeno, PT

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1669574331
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT14165 Issued in FL
Practice address
12780 Waterford Lakes Pkwy
Suite 115
Orlando, FL 32828-4500
Phone
(407) 207-7188
Fax
(407) 207-7103
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT14165 FL Primary

Addresses

Primary practice location

12780 Waterford Lakes Pkwy
Suite 115
Orlando, FL 32828-4500

Mailing address

12780 Waterford Lakes Pkwy
Suite 115
Orlando, FL 32828-4500
Phone (407) 207-7188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050930000080 FL Practitioner - Physical Therapist in Private Practice 3375578214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Sports Medicine Group IncGroup PAC ID 0840225785, 12 clinicians

Practice addresses (Care Compare)

12780 Waterford Lakes Pkwy
Suite 115
Orlando, FL 32828-4501
Phone (407) 207-7188

1615 Edgewater Dr
Suite 180
Orlando, FL 32804-5851
Phone (407) 601-6412

745 Orienta Ave
Suite 1015
Altamonte Springs, FL 32701-5675
Phone (407) 332-7816

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Sports Medicine Group Inc Physical Therapist CurrentSince Sep 30, 2004 Accepting new patients

Locations

12780 Waterford Lakes Pkwy
Ste 115
Orlando, FL 32828
Phone (407) 207-7188

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669574331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12780 WATERFORD LAKES PKWY",
            "address_2": "SUITE 115",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284500",
            "telephone_number": "407-207-7188",
            "fax_number": "407-207-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12780 WATERFORD LAKES PKWY",
            "address_2": "SUITE 115",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284500",
            "telephone_number": "407-207-7188",
            "fax_number": "407-207-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENO",
        "first_name": "ERIC",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT14165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.