Scott A Green, D.O.

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

000346 Issued in CT

Practice address

35 Kennedy Dr
Putnam, CT 06260-1939

Phone

(860) 963-2133

Fax

(860) 963-8955

NPI assigned

Jun 30, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Interoperability endpoints

• Direct secure messaging: scotta.green@xdr.hhchealthdirect.org

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1003813502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 KENNEDY DR",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601939",
            "telephone_number": "860-963-2133",
            "fax_number": "860-963-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 KENNEDY DR",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601939",
            "telephone_number": "860-963-2133",
            "fax_number": "860-963-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "CT",
            "license": "000346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001003467",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nelson Gonzalez
• Chandler Landers Gottshall
• Erin Gouldsbrough, FNP-C
• Kayla Ashley Goulette
• Green Valley Orthodontics PLLC
• Denniell Grijalva
• Autumn Starr Grimshaw
• Anne Marie Grossi, APRN
• Holly J Gudeahn, LO
• Lisa Michelle Guilbault, PT

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Putnam, CT
• Providers in Putnam, CT by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.