Organization Active NPI

Burt M Greenberg MD PC

  • Plastic Surgery Physician
  • Great Neck, NY
National Provider Identifier
1679879746
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
169340-1 Issued in NY
Legal business name
BURT M GREENBERG MD PC
Practice address
833 Northern Blvd
Suite 230
Great Neck, NY 11021-5315
Phone
(516) 466-6600
Fax
(516) 466-6603
NPI assigned
Feb 7, 2011
Last updated
Feb 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Authorized official

Name
Mrs. Deb Klivansky
Title
Practice Administrator
Phone
(516) 466-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 169340-1 NY Primary

Addresses

Primary practice location

833 Northern Blvd
Suite 230
Great Neck, NY 11021-5315

Mailing address

833 Northern Blvd
Suite 230
Great Neck, NY 11021-5315
Phone (516) 466-6600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090730000266 NY Part B Supplier - Clinic/Group Practice 0840343398 Receives reassigned benefits from 1 practitioner
Practice locations: Great Neck, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1679879746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 NORTHERN BLVD",
            "address_2": "SUITE 230",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215315",
            "telephone_number": "516-466-6600",
            "fax_number": "516-466-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 NORTHERN BLVD",
            "address_2": "SUITE 230",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215315",
            "telephone_number": "516-466-6600",
            "fax_number": "516-466-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURT M GREENBERG MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-07",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "KLIVANSKY",
        "authorized_official_first_name": "DEB",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "516-466-6600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "169340-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.