NPIMap

Organization Active NPI

Arnold Greenberg MD Inc

Doing business as Manzanita Medical Clinic

  • Neurology Physician
  • Carmichael, CA
National Provider Identifier
1700977188
Registry record updated Apr 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
ARNOLD GREENBERG MD INC
Doing business as
Manzanita Medical Clinic
Practice address
5810 Jameson CT
Ste 1
Carmichael, CA 95608
Phone
(916) 979-0621
Fax
(916) 979-1110
NPI assigned
Sep 28, 2006
Last updated
Apr 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2020

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

Authorized official

Name
Larisa Kravchuk
Title
Manager
Phone
(916) 979-0621

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

5810 Jameson CT
Ste 1
Carmichael, CA 95608

Mailing address

5810 Jameson CT
Carmichael, CA 95608-0881
Phone (916) 979-0621

Other names 1

  • Manzanita Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000540 CA Part B Supplier - Clinic/Group Practice 6507765971 Receives reassigned benefits from 10 practitioners
Practice locations: Carmichael, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0932652Arnold Greenberg MD Inc5810 Jameson Court, Carmichael, CA 95608Certificate of waiverJun 20, 2028

National Provider Directory

National Provider Directory

Locations

5810 Jameson Ct
Ste 1
Carmichael, CA 95608
Phone (916) 979-0621

5810 Jameson Ct
Ste 5
Carmichael, CA 95608
Phone (916) 500-4510

804 Harbor Blvd
West Sacramento, CA 95691
Phone (415) 346-7505

Practitioners & affiliated clinicians

Practitioners 12

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": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588204800000",
    "number": "1700977188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 JAMESON CT",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080881",
            "telephone_number": "916-979-0621",
            "fax_number": "916-979-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 JAMESON CT",
            "address_2": "STE 1",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "95608",
            "telephone_number": "916-979-0621",
            "fax_number": "916-979-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARNOLD GREENBERG MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A",
        "authorized_official_last_name": "KRAVCHUK",
        "authorized_official_first_name": "LARISA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "916-979-0621"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manzanita Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Manzanita Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carmichael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; 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.