Mathias M Green

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

419 E 7TH St Ste 207
The Dalles, OR 97058-2676

Phone

(541) 296-5452

Fax

(541) 296-1537

NPI assigned

Dec 4, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid-Columbia Center for LivingGroup PAC ID 4385540186, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mid-Columbia Center for Living

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • The Dalles, OR
  • NPI 1699745794
  Medicare reassignment Care Compare group NPD
• Mid-Columbia Center for Living

  • Community/Behavioral Health Agency
  • The Dalles, OR
  • NPI 1275954513
  NPD
• Mid-Columbia Center for Living

  • Community/Behavioral Health Agency
  • Hood River, OR
  • NPI 1831510155
  NPD (past)

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1003321753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 HEATHROW WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044004",
            "telephone_number": "541-858-8170",
            "fax_number": "541-858-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 E 7TH ST STE 207",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970582676",
            "telephone_number": "541-296-5452",
            "fax_number": "541-296-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MATHIAS",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa C Grant, M.D.
• Greater Oregon Behavioral Health Inc
• Greater Oregon Behavioral Health Inc
• Greater Oregon Behavioral Health Inc
• Kathleen Marie Green, LCSW
• Tiffany Christine Greenslade
• Nicole Gregerson-Hollenbeck
• Ashley Griffith
• Patrick Grimsley, M.D.
• Hannah Michele Grooms, BA

• Mental Health Counselor in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.
• 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.