Active NPI
Laurence Paul Greenberg, PT, MS, M.ED.
- Orthopedic Physical Therapist
- West Tisbury, MA
National Provider Identifier
1972649440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- AH 3703-PT
- Practice address
- 170 Pond Rd
West Tisbury, MA 02575-0130 - Phone
- (508) 696-9171
- Fax
- (508) 696-0770
- NPI assigned
- Jan 30, 2007
- Last updated
- Feb 17, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | AH 3703-PT | MA | |
| Orthopedic Physical Therapist | 2251X0800X | AH 3703-PT | MA | Primary |
Addresses
Primary practice location
170 Pond Rd
West Tisbury, MA 02575-0130
Mailing address
PO Box 130
West Tisbury, MA 02575-0130
Phone (508) 696-9171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060419000109 | MA | Practitioner - Physical Therapist in Private Practice | 9931118940 | Practice locations: West Tisbury, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
170 Pond Rd
West Tisbury, MA 02575-0130
Phone (508) 696-9171
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AH 3703-PT | MA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266364800000",
"number": "1972649440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 130",
"city": "WEST TISBURY",
"state": "MA",
"postal_code": "025750130",
"telephone_number": "508-696-9171",
"fax_number": "508-696-0770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 POND RD",
"city": "WEST TISBURY",
"state": "MA",
"postal_code": "025750130",
"telephone_number": "508-696-9171",
"fax_number": "508-696-0770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBERG",
"first_name": "LAURENCE",
"middle_name": "PAUL",
"name_prefix": "Mr.",
"credential": "PT, MS, M.ED.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2010-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "MA",
"license": "AH 3703-PT",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MA",
"license": "AH 3703-PT",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Tisbury, MA
- Hannah Elias
- Peter Cosmo Engley
- Susan M Fieldsmith, LMHC
- Lila Merrily Fischer, C.P.M.
- Leia Marie French, CPM
- Martha's Vineyard Orthopedic Surgery and Sports Medicine (Monto Orthopedics)
- Martha's Vineyard Orthopedic Surgery and Sports Medicine (Monto Orthopedics)
- Marthas Vineyard Ear Nose and Throat Specialists PC
- Bryan P McShea, D.C.
- Karen F Meeks, LICSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.