Individual provider Active NPI

Daniel Right Greenberg, M.D.

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1952398919
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036072134 Issued in IL
Practice address
2740 W Foster Ave
Ste 301
Chicago, IL 60625
Phone
(773) 271-3139
Fax
(773) 293-8772
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036072134 IL Primary

Addresses

Primary practice location

2740 W Foster Ave
Ste 301
Chicago, IL 60625

Mailing address

2740 W Foster Ave
LL7
Chicago, IL 60625
Phone (773) 878-8200

Other identifiers 4

IdentifierTypeStateIssuer
F400195669OtherILMEDICARE INDIVIDUAL PTAN
036072134OtherILMEDICAID NUMBER FOR SCMG
036072134MedicaidIL
406120OtherILMEDICARE PTAN FOR SCMG

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgreenberg277023@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20041206001034 IL Practitioner - Ophthalmology 6800852443 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036072134ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Ophthalmology CurrentSince Apr 1, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Apr 1, 2021 Accepting new patients
Swedish Covenant Management Services, Inc. CurrentSince Mar 1, 2015 Accepting new patients
Swedish Covenant Management Services, Inc CurrentSince Mar 1, 2015 Accepting new patients

Locations

7463 Solutions Ctr
Chicago, IL 60677

2740 W Foster Ave
Ste LL7
Chicago, IL 60625

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

2740 W Foster Ave
Ste 301
Chicago, IL 60625
Phone (773) 271-3139

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

800 Austin St
Ste 256E
Evanston, IL 60202
Phone (847) 674-8761

800 Austin St
Ste 256
Evanston, IL 60202
Phone (847) 495-8434

Interoperability endpoints

  • Direct secure messaging: dgreenberg277023@direct.northshore.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1952398919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "LL7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "773-878-8200",
            "fax_number": "773-293-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE",
            "address_2": "STE 301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "773-271-3139",
            "fax_number": "773-293-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "DANIEL",
        "middle_name": "RIGHT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036072134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL  PTAN",
            "identifier": "F400195669",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID NUMBER FOR SCMG",
            "identifier": "036072134",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036072134",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN FOR SCMG",
            "identifier": "406120",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgreenberg277023@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2740 W Foster Ave",
            "address_2": "Ste 301",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.