Individual provider Active NPI

Laurence Paul Greenberg, PT, MS, M.ED.

  • Orthopedic Physical Therapist
  • West Tisbury, MA
National Provider Identifier
1972649440
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
AH 3703-PT Issued in MA
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, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
AH 3703-PTMAMDOrthopedic 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

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.

Verify at the official NPI Registry.