Robert S Greenbaum, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

004414 Issued in NY

Practice address

1110 Route 55 Ste 105
Lagrangeville, NY 12540-5048

Phone

(845) 473-0220

Fax

(845) 473-0140

NPI assigned

Jun 22, 2005

Reactivated

Oct 10, 2007

Last updated

Dec 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Optometry

Education

State University of New York - State College Optometry, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

200 West Optics LLCGroup PAC ID 5395144380, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• 200 West Optics, LLC

  dba MyEyeDr.

  • Optometrist
  • Brewster, NY
  • NPI 1831770890
  Medicare reassignment Care Compare group NPD
• Robert S Greenbaum OD PLLC

  • Optometrist
  • Lagrangeville, NY
  • NPI 1144208208
  Medicare reassignment NPD Authorized official
• 200 West Optics, LLC

  dba MyEyeDr.

  • Optometrist
  • Astoria, NY
  • NPI 1104592278
  NPD
• 200 West Optics, LLC

  • Optometrist
  • New York, NY
  • NPI 1205787520
  NPD
• Moriarty Physical Therapy, P.C.

  • Physical Therapist
  • Poughkeepsie, NY
  • NPI 1245200518
  NPD (past)

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1750387973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ROUTE 55 STE 105",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405048",
            "telephone_number": "845-473-0220",
            "fax_number": "845-473-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBAUM",
        "first_name": "ROBERT",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "deactivation_date": "2006-01-14",
        "reactivation_date": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "004414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10032470",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007187044",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH INSURANCE",
            "identifier": "P2790040",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02144998",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH PLAN",
            "identifier": "597014",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Gomes, M.S.
• Veronica Gordon
• Rachel Lynn Grahn, LCSW
• John P Granger, DMD
• Great Atlantic & Pacific Tea Company Inc (A & P Pharmacy)
• Michelle A Grossman, RDMS
• Julissa Guzman
• Health Quest Medical Practice
• Madeline J Hildreth, DC
• Christian Hilts

• Optometrist in Lagrangeville, NY
• Providers in Lagrangeville, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.