Individual provider Active NPI

Harvey M Greenberg, MD

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
National Provider Identifier
1841282423
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G67540 Issued in CA
Practice address
11995 Singletree LN
Eden Prairie, MN 55344-5347
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X TL31053 SC
Diagnostic Radiology Physician 2085R0202X G67540 CA Primary

Addresses

Primary practice location

11995 Singletree LN
Eden Prairie, MN 55344-5347

Mailing address

11995 Singletree LN
Eden Prairie, MN 55344-5347
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 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
I20050210000965 CA Practitioner - Diagnostic Radiology 3476505140 Reassigns benefits to 3 organizations
I20231017002585 IL Practitioner - Diagnostic Radiology 3476505140 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G67540CAMDDiagnostic Radiology Physician
TL31053SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Alliance PC Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Donalsonville Hospital Inc CurrentSince May 1, 2020 Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Current Accepting new patients
Hospital & Medical Foundation of Paris, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Hospital & Medical Foundation of Paris, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Georgia Magnetic Imaging Center LTD Diagnostic Radiology CurrentSince Feb 15, 2022 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Radiology Associates LLP Diagnostic Radiology Past Accepting new patients
Foundation Health Systems Corp. Past Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
Pee Dee Radiology Group PA Past Accepting new patients
Midcoast Imaging Medical Group Diagnostic Radiology PastSince Feb 16, 2020 Accepting new patients

Locations

102 Hospital Cir
Donalsonville, GA 39845
Phone (229) 524-8489

721 E Court St
Paris, IL 61944
Phone (217) 465-4141

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1841282423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445347",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445347",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "HARVEY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "TL31053",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G67540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.