Omar Green, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

883 Paddock Avenue
Rushford Center Inc
Meriden, CT 06450-7044

Phone

(203) 630-5280

NPI assigned

Dec 4, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: omar.green@xdr.hhchealthdirect.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.

• State of Connecticut

  • Psychiatric Hospital
  • Hartford, CT
  • NPI 1487689022
  Medicare reassignment NPD
• Talk Therapy LLC

  • Clinical Social Worker
  • Bloomfield, CT
  • NPI 1174155907
  NPD Authorized official
• State of Connecticut

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD

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

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619913600000",
    "number": "1063843845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "883 PADDOCK AVENUE",
            "address_2": "RUSHFORD CENTER INC",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507044",
            "telephone_number": "203-630-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 PADDOCK AVENUE",
            "address_2": "RUSHFORD CENTER INC",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507044",
            "telephone_number": "203-630-5280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "693 Bloomfield Ave",
            "address_purpose": "LOCATION",
            "city": "Bloomfield",
            "state": "CT",
            "postal_code": "060022489",
            "country_code": "US",
            "telephone_number": "860-243-6584",
            "fax_number": "860-243-6591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "OMAR",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-04",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "000085",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Graeber'S Pharmacy Inc
• Graeber'S Pharmacy Inc
• Great Hills LLC
• Great Hills LLC
• Miranda Green, RDH
• Portia Green
• Susan Marie Green, RDN, CDN
• Barbara J. Greten, M.DIV., MSW, LCSW
• Eliza Grigoriciuc, MD
• Marisa Grodzicki

• Clinical Social Worker in Meriden, CT
• Providers in Meriden, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2021; 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.