Harry Miguel Green, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13578T Issued in CA

Practice address

4641 Missouri Flat Rd
Placerville, CA 95667-6816

Phone

(510) 642-0749

NPI assigned

Jul 25, 2008

Sex

Male

Sole proprietor

Yes

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 CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of California - School of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regents of the University of California at BerkeleyGroup PAC ID 8628083110, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: harry.green.p1@direct.aphcv.nextgenshare.com
• Direct secure messaging: hgreen348917@direct-ucsfmedicalcenter.org

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.

• Regents of the University of California at Berkeley

  • Optometrist
  • Berkeley, CA
  • NPI 1306908058
  Medicare reassignment Care Compare group NPD
• Capital Pediatric Cardiology Associates Inc

  • Pediatric Cardiology Physician
  • Sacramento, CA
  • NPI 1508211277
  NPD (past)
• El Dorado County Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Placerville, CA
  • NPI 1316050107
  NPD (past)

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1013172477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4327 GOLDEN CENTER DR",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676287",
            "telephone_number": "530-621-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 MISSOURI FLAT RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676816",
            "telephone_number": "510-642-0749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9104 Ponte Morino Dr",
            "address_2": "ste 110",
            "address_purpose": "LOCATION",
            "city": "Cameron Park",
            "state": "CA",
            "postal_code": "95682",
            "country_code": "US",
            "telephone_number": "530-621-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "HARRY",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13578T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary M Gough, LCSW
• Dylan Grady
• Christina Elizabeth Graham
• Grandpas Compounding Pharmacy Inc (Grandpas Compounding Pharmacy)
• Pamela Granick
• Douglas K. Greenwald, D.D.S.,M.S.
• Kimberly Jean Grissom, NA
• Lisa Groby
• Glenn Arthur Gross, R.PH.
• Tyler Gruber

• Optometrist in Placerville, CA
• Providers in Placerville, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.