Active NPI
Marc A Greenwald, MD
- Internal Medicine Physician
- Brockton, MA
National Provider Identifier
1700850807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 220491
- Practice address
- 680 Centre Street
Brockton, MA 02302 - Phone
- (508) 941-7202
- Fax
- (508) 941-6388
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 220491 | MA | Primary |
Addresses
Primary practice location
680 Centre Street
Brockton, MA 02302
Mailing address
680 Centre Street
Brockton, MA 02302
Phone (508) 941-7202
Other identifiers 16
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0406618 | Other | EVERCARE | |
| 4094854 | Other | AETNA US HEALTHCARE | |
| 4599158 | Other | CIGNA HEALTH PLAN | |
| AA10928 | Other | HARVARD PILGRIM | |
| J27427 | Other | BLUE SHIELD INDEMNITY | |
| 67982 | Other | FALLON COMM HEALTH PLAN | |
| 042472266 | Other | PRIVATE HEALTHCARE SYSTEM | |
| 2225093 | Other | FIRST HEALTH | |
| 042472266 | Other | THREE RIVERS | |
| 467892 | Other | TUFTS HEALTH PLAN | |
| 042472266 | Other | ONE HEALTH PLAN | |
| J27427 | Other | BLUE SHIELD HMO BLUE | |
| 042472266 | Other | UNITED HEALTHCARE | |
| 2037114 | Medicaid | MA | |
| 784025 | Other | MVP HEALTH CARE | |
| J27427 | Other | BLUE CARE ELECT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 220491 | MA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guthrie Medical Group, P.C. | Past | Accepting new patients | |
| Bridgewater Goddard Park Medical Associates, Inc. | Past | Accepting new patients |
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.
-
- Multi-Specialty Clinic/Center
- Brockton, MA
- NPI 1417932591
-
- Family Medicine Physician
- Troy, PA
- NPI 1376592493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304467200000",
"number": "1700850807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "680 CENTRE STREET",
"city": "BROCKTON",
"state": "MA",
"postal_code": "02302",
"telephone_number": "508-941-7202",
"fax_number": "508-941-6388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 CENTRE STREET",
"city": "BROCKTON",
"state": "MA",
"postal_code": "02302",
"telephone_number": "508-941-7202",
"fax_number": "508-941-6388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENWALD",
"first_name": "MARC",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2011-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "220491",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "0406618",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "4094854",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTH PLAN",
"identifier": "4599158",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "AA10928",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD INDEMNITY",
"identifier": "J27427",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMM HEALTH PLAN",
"identifier": "67982",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTHCARE SYSTEM",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2225093",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THREE RIVERS",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "467892",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ONE HEALTH PLAN",
"identifier": "042472266",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD HMO BLUE",
"identifier": "J27427",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "042472266",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2037114",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP HEALTH CARE",
"identifier": "784025",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE ELECT",
"identifier": "J27427",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.