Individual provider Active NPI

Stuart L Greenberg, O.D.

  • Optometrist
  • Scottsdale, AZ
National Provider Identifier
1710022736
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD890 Issued in AZ
Practice address
11219 E Via Linda
#3
Scottsdale, AZ 85259-4069
Phone
(480) 451-4519
Fax
(480) 451-4858
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD890 AZ Primary

Addresses

Primary practice location

11219 E Via Linda
#3
Scottsdale, AZ 85259-4069

Mailing address

11219 E Via Linda
#3
Scottsdale, AZ 85259-4069
Phone (480) 451-4519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051128000285 AZ Practitioner - Optometry 9133149883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11219 E Via Linda
D3
Scottsdale, AZ 85259-4069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD890AZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ancala Eye Care P C Optometrist CurrentSince Dec 14, 2016 Accepting new patients

Locations

11219 E Via Linda
Ste D3
Scottsdale, AZ 85259
Phone (480) 451-4519

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1710022736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11219 E VIA LINDA",
            "address_2": "#3",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852594069",
            "telephone_number": "480-451-4519",
            "fax_number": "480-451-4858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11219 E VIA LINDA",
            "address_2": "#3",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852594069",
            "telephone_number": "480-451-4519",
            "fax_number": "480-451-4858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "STUART",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OD890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.