NPIMap

Patrick Green MD PLLC

A Medicare group practice based in Tooele, UT: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 6204000102), with 16 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
6204000102The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part B Supplier - Clinic/Group Practice, Part B Supplier - Opioid Treatment Program (Otp)
Enrolled in
UT
Enrollments
2
Group size
8 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
2In 1 place

Enrollment records 2

Enrollment IDStateProvider typeNPI
O20111110000358 UT Part B Supplier - Clinic/Group Practice 1518256650
O20250827000902 UT Part B Supplier - Opioid Treatment Program (Otp) 1053187310

NPIs in this group 2

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 16

Clinicians who reassign their Medicare benefits to this group (16) or whom Care Compare lists as members (8).

Sources for this page