Individual provider Active NPI

Stephen Robert Greenberg, M.D.

  • Ophthalmology Physician
  • Holbrook, NY
National Provider Identifier
1699878587
Registry record updated Feb 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
106798 Issued in NY
Practice address
233 Union Avenue
Suite 104/105
Holbrook, NY 11741-1820
Phone
(631) 285-7311
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/Technologist 156FX1100X 106798 NY
Ophthalmology Physician 207W00000X 106798 NY Primary

Addresses

Primary practice location

233 Union Avenue
Suite 104/105
Holbrook, NY 11741-1820

Mailing address

260 E Middle Country Rd
Suite 201
Smithtown, NY 11787-2982
Phone (631) 265-8780

Other identifiers 1

IdentifierTypeStateIssuer
00187595MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051116000020 NY Practitioner - Ophthalmology 7113946476 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
106798NYMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sight Medical Doctors PLLC Ophthalmology CurrentSince Apr 1, 2014 Accepting new patients
Sight Medical Doctors PLLC CurrentSince Apr 1, 2014 Accepting new patients

Locations

590 Nicolls Rd
Ste 1
Deer Park, NY 11729

125 Kennedy Dr
Ste 400
Hauppauge, NY 11788

233 Union Ave
Ste 105
Holbrook, NY 11741
Phone (631) 285-7311

260 E Middle Country Rd
Ste 201
Smithtown, NY 11787
Phone 6312658780150

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423440000000",
    "number": "1699878587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E MIDDLE COUNTRY RD",
            "address_2": "SUITE 201",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872982",
            "telephone_number": "631-265-8780",
            "fax_number": "631-265-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 UNION AVENUE",
            "address_2": "SUITE 104/105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411820",
            "telephone_number": "631-285-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "STEPHEN",
        "middle_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2015-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "NY",
            "license": "106798",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "106798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00187595",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

Verify at the official NPI Registry.