Active NPI
Stephan Michael Greenberg, M.D.
- Ophthalmology Physician
- Hornell, NY
National Provider Identifier
1881792604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 099238
- Practice address
- 7 Erie Ave
Hornell, NY 14843-1909 - Phone
- (607) 324-4480
- Fax
- (607) 324-3453
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 099238 | NY | Primary |
Addresses
Primary practice location
7 Erie Ave
Hornell, NY 14843-1909
Mailing address
7 Erie Ave
PO Box 578
Hornell, NY 14843-1909
Phone (607) 324-4480
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 161003515 | Other | NY | TAX ID |
| 00663272 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakes Radiology PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Hornell, NY
- NPI 1710937727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480377600000",
"number": "1881792604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 ERIE AVE",
"address_2": "PO BOX 578",
"city": "HORNELL",
"state": "NY",
"postal_code": "148431909",
"telephone_number": "607-324-4480",
"fax_number": "607-324-3453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 ERIE AVE",
"city": "HORNELL",
"state": "NY",
"postal_code": "148431909",
"telephone_number": "607-324-4480",
"fax_number": "607-324-3453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBERG",
"first_name": "STEPHAN",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2016-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NY",
"license": "099238",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "161003515",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00663272",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hornell, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.