Individual provider Active NPI

Jared Ross Green, M.D.

  • Diagnostic Radiology Physician
  • Hollywood, FL
National Provider Identifier
1053585604
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036.130117 Issued in IL
Practice address
1005 Joe Dimaggio Dr
Hollywood, FL 33021-5402
Phone
(954) 265-5892
NPI assigned
Apr 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 036.130117 IL
Diagnostic Radiology Physician 2085R0202X 036.130117 IL Primary

Addresses

Primary practice location

1005 Joe Dimaggio Dr
Hollywood, FL 33021-5402

Mailing address

500 N Hiatus Rd Ste 200
Pembroke Pines, FL 33026-5213
Phone (954) 437-4800

Other practice location 1

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 987-2000

Other practice location 2

500 N Hiatus Rd Ste 200
Pembroke Pines, FL 33026-5213
Phone (954) 437-4800

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jgreen265621@MHSDIRECT.NET
Direct Messaging Address jared.green@sep.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210315002064 FL Practitioner - Diagnostic Radiology 8325360803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Miami, LM Miller School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

1005 Joe Dimaggio Dr
Hollywood, FL 33021-5402
Phone (904) 399-5550

13695 US Hwy 1
Sebastian, FL 32958-3230
Phone (904) 399-5550

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 399-5550

3600 Washington St
Hollywood, FL 33021-8216
Phone (904) 399-5550

500 N Hiatus Rd
Suite 200
Pembroke Pines, FL 33026-5213
Phone (904) 399-5550

7800 Sheridan St
Pembroke Pines, FL 33024-2536
Phone (904) 399-5550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.130117ILMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mori Bean and Brooks Inc Pediatric Radiology CurrentSince Oct 1, 2025 Accepting new patients
Radiology Associates of Hollywood, Inc. Diagnostic Radiology Past Accepting new patients

Locations

1005 N 35th Ave
Hollywood, FL 33021
Phone (954) 265-5324

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

500 N Hiatus Rd
Ste 200
Pembroke Pines, FL 33026
Phone 9544374800 ext. 2133

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

Interoperability endpoints

  • Direct secure messaging: jgreen265621@mhsdirect.net
  • Direct secure messaging: jared.green@sep.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1053585604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N HIATUS RD STE 200",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330265213",
            "telephone_number": "954-437-4800",
            "fax_number": "954-437-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 JOE DIMAGGIO DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215402",
            "telephone_number": "954-265-5892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Johnson St",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330215421",
            "country_code": "US",
            "telephone_number": "954-987-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 N Hiatus Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330265213",
            "country_code": "US",
            "telephone_number": "954-437-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JARED",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "IL",
            "license": "036.130117",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.130117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgreen265621@MHSDIRECT.NET",
            "affiliation": "N",
            "address_1": "Radiology Associates of Hollywood, Inc.",
            "address_2": "Suite 200",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jared.green@sep.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 N Hiatus Rd Ste 200",
            "city": "Pembroke Pines",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330265213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.