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Individual provider Active NPI

Brett B Greenky, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Fayetteville, NY
National Provider Identifier
1750346060
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
170239 Issued in NY
Practice address
4115 Medical Center Dr
Fayetteville, NY 13066-6636
Phone
(315) 329-7600
Fax
(315) 329-7608
NPI assigned
Apr 19, 2006
Last updated
Aug 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 170239 NY
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 170239 NY Primary

Addresses

Primary practice location

4115 Medical Center Dr
Fayetteville, NY 13066-6636

Mailing address

5719 Widewaters Pkwy
Syracuse, NY 13214-1880
Phone (315) 251-3100

Other identifiers 1

IdentifierTypeStateIssuer
01360021MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100315000076 NY Practitioner - Orthopedic Surgery 1850426016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5719 Widewaters Pkwy
Syracuse, NY 13214-1985
Phone (315) 251-3100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement89
Knee replacement142
Lower limb (leg) arthroscopy (minimally invasive joint repair)24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
170239NYMDAdult Reconstructive Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Orthopedic Specialists, PC Orthopaedic Surgery CurrentSince May 14, 2002 Accepting new patients
Rome Memorial Hospital, Inc. Current Accepting new patients
Syracuse Orthopedic Specialists, PLLC Orthopaedic Surgery CurrentSince May 14, 2002 Accepting new patients

Locations

4115 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7600

7209 Buckley Rd
Liverpool, NY 13088
Phone (315) 299-5451

107 E Chestnut St
Ste 102
Rome, NY 13440
Phone (315) 338-9200

1500 N James St
Rome, NY 13440
Phone (315) 338-7000

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

5801 E Taft Rd
Syracuse, NY 13212
Phone (315) 418-4140

Interoperability endpoints

  • Direct secure messaging: brettgreenky@sos.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1750346060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5719 WIDEWATERS PKWY",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132141880",
            "telephone_number": "315-251-3100",
            "fax_number": "315-449-9923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 MEDICAL CENTER DR",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130666636",
            "telephone_number": "315-329-7600",
            "fax_number": "315-329-7608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENKY",
        "first_name": "BRETT",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "170239",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "NY",
            "license": "170239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01360021",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

Verify at the official NPI Registry.