Organization Active NPI

Mitchell Greenbaum, DPM, PC

  • Foot Surgery Podiatrist
  • Plainview, NY
National Provider Identifier
1851577928
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
N004558 Issued in NY
Legal business name
MITCHELL GREENBAUM, DPM, PC
Practice address
525 Woodbury Rd
Plainview, NY 11803-1004
Phone
(516) 484-1444
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Mitchell A. Greenbaum, D.P.M.NPI 1104801448
Title
Owner
Phone
(516) 484-1444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X N004558 NY Primary

Addresses

Primary practice location

525 Woodbury Rd
Plainview, NY 11803-1004

Mailing address

525 Woodbury Rd
Plainview, NY 11803-1004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930021672 NY DME Supplier - Physician - Podiatry 2466658687 Practice locations: Plainview, NY
O20101109001063 NY Part B Supplier - Clinic/Group Practice 2466658687 Receives reassigned benefits from 2 practitioners
Practice locations: Plainview, NY; Roslyn Heights, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1851577928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 WOODBURY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WOODBURY RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031004",
            "telephone_number": "516-484-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL GREENBAUM, DPM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "GREENBAUM",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-484-1444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NY",
            "license": "N004558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainview, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.