Steven S Greenbaum, MD

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

MD041412E Issued in PA

Practice address

1528 Walnut St
Suite 1101 Dermatologic Surgical Assoc
Philadelphia, PA 19102

Phone

(215) 735-4994

Fax

(215) 735-8473

NPI assigned

Oct 4, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942395207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 WALNUT ST",
            "address_2": "SUITE 1101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-735-4994",
            "fax_number": "215-735-8376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 WALNUT ST",
            "address_2": "SUITE 1101 DERMATOLOGIC SURGICAL ASSOC",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-735-4994",
            "fax_number": "215-735-8473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBAUM",
        "first_name": "STEVEN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "PA",
            "license": "MD041412E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0087713000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA BLUE SHIELD",
            "identifier": "170232",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marie Green
• Susan Robin Green, MSN, CRNP
• Tkeyah Krystal Green
• William Green III
• Meridith Greenbaum, LCSW
• Adam Seth Greenberg, CRNP
• Adena Greenberg, MD
• Cristin Greenberg, CRNP
• Crystal Greenberg
• Eva M Greenberg, PHD

• Procedural Dermatology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Procedural Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.