Scott R Greenberg, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD065771L Issued in PA

Practice address

101 S. Bryn Mawr Ave
300A
Bryn Mawr, PA 19010-3124

Phone

(833) 440-4325

Fax

(484) 380-2115

NPI assigned

Jan 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2013 through Jan 1, 2027

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1972653384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S. BRYN MAWR AVE",
            "address_2": "300A",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103124",
            "telephone_number": "833-440-4325",
            "fax_number": "484-380-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S. BRYN MAWR AVE",
            "address_2": "300A",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103124",
            "telephone_number": "833-440-4325",
            "fax_number": "484-380-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "SCOTT",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA69121",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD065771L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "22-3005391",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Green Healthcare Associates, Inc.
• Emily Rose Green, MSN, CNM, WHNP-BC
• Ilan Green, DC
• Sean Dennis Green Sr., M.D.
• Sandra Greenberg, ED.D., LCSW, BCD
• Greene House Counseling,LLC
• Angela Greene, LCSW
• Eric John Greene, PA-C
• Pauline Elaine Greene
• Ari Chaim Greis, DO

• Family Medicine Physician in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.