Individual provider Active NPI

Leslie A Greene, M.D.

  • Family Medicine Physician
  • Everett, WA
National Provider Identifier
1043478993
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60409811 Issued in WA
Practice address
3927 Rucker Ave
Everett, WA 98201-4833
Phone
(425) 339-5422
Fax
(425) 339-5444
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD28802 ME
Family Medicine Physician 207Q00000X MD60409811 WA Primary

Addresses

Primary practice location

3927 Rucker Ave
Everett, WA 98201-4833

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 258-3900

Other practice location 1

6100 NE Fourth Plain Blvd
Vancouver, WA 98661-6830
Phone (360) 947-2550

Other practice location 2

5 Central Maine Xing
Gardiner, ME 04345-6320
Phone (207) 582-6608

Other identifiers 1

IdentifierTypeStateIssuer
2047790MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ME2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151016001145 WA Practitioner - Family Practice 3870732423 Reassigns benefits to 2 organizations
I20250212001103 ME Practitioner - Family Practice 3870732423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Maryland School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

5 Central Maine Xing
Gardiner, ME 04345-6320
Phone (207) 582-6608

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD28802MEMDFamily Medicine Physician
MD60409811WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Feb 10, 2025 Accepting new patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Nov 25, 2024 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Oct 5, 2015 Accepting new patients
Mainegeneral Medical Center CurrentSince Feb 10, 2025 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Oct 5, 2015 Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Nov 25, 2024 Accepting new patients

Locations

5 Central Maine Xing
Gardiner, ME 04345
Phone (207) 582-6608

149 North St
Waterville, ME 04901
Phone (207) 622-1959

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419

3927 Rucker Ave
Ste 202
Everett, WA 98201

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

7410 Delaware Ln
Vancouver, WA 98664
Phone (360) 566-4402

6100 NE Fourth Plain Blvd
Vancouver, WA 98661
Phone (360) 891-7300

Interoperability endpoints

  • Direct secure messaging: lesliegreene@mgh.allscriptsdirect.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1043478993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-258-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-339-5422",
            "fax_number": "425-339-5444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6100 NE Fourth Plain Blvd",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986616830",
            "country_code": "US",
            "telephone_number": "360-947-2550",
            "fax_number": "360-947-2533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Central Maine Xing",
            "address_purpose": "LOCATION",
            "city": "Gardiner",
            "state": "ME",
            "postal_code": "043456320",
            "country_code": "US",
            "telephone_number": "207-582-6608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE",
        "first_name": "LESLIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD28802",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60409811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2047790",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.