Individual provider Active NPI

Mark Greenwald

  • Ophthalmology Physician
  • Denver, CO
National Provider Identifier
1720144975
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
DR.0070955 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4597
Phone
(303) 436-4949
Fax
(303) 602-4560
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036055837 IL
Ophthalmology Physician 207W00000X DR.0070955 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4597

Mailing address

777 Bannock St
Denver, CO 80204-4597
Phone (303) 436-4949

Other practice location 1

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgreenwaldmd8882@uchospital.direct-ci.com University of Chicago Physicians Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041112000737 IL Practitioner - Ophthalmology 5799677530 Reassigns benefits to 3 organizations
I20230718001659 CO Practitioner - Ophthalmology 5799677530 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036055837ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County CurrentSince Jul 20, 2018 Accepting new patients
Denver Health and Hospital Authority CurrentSince May 8, 2023 Accepting new patients
Illinois College of Optometry CurrentSince Jul 1, 2018 Accepting new patients
Cook County CurrentSince Jul 20, 2018 Accepting new patients
University of Chicago CurrentSince Oct 15, 2004 Accepting new patients
Cook County Current Accepting new patients
Denver Health and Hospital Authority CurrentSince May 8, 2023 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

180 Harvester Dr
Ste 110
Burr Ridge, IL 60527
Phone (773) 702-1061

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

3241 S Michigan Ave
Chicago, IL 60616
Phone (312) 225-6200

1900 W Polk St
Ste 1200
Chicago, IL 60612

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mgreenwaldmd8882@uchospital.direct-ci.com
  • Direct secure messaging: mgreenwald254696@direct.dhha.org

Organizations & group practices 7

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1720144975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-4949",
            "fax_number": "303-602-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-436-4949",
            "fax_number": "303-602-4560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "888-824-0200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENWALD",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036055837",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "DR.0070955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgreenwaldmd8882@uchospital.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "University of Chicago Physicians Group",
            "address_1": "5841 S Maryland Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606371443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.