Miyoko Stephanie Green, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0003732 Issued in CO

Practice address

2446 Research Pkwy
Suite 200
Colorado Springs, CO 80920-1087

Phone

(719) 623-1050

Fax

(719) 623-1052

NPI assigned

Jul 9, 2013

Sex

Female

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

Other names 1

• Miyoko G. Ivis Former name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Centers of Colorado LLCGroup PAC ID 2365714540, 327 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital - Interquest Hospital, Colorado Springs, CO, CCN 060133

Merit-based Incentive Payment System (MIPS)

Final score

43.24 of 100Reported as group

Quality

73.53

Promoting interoperability

0

Improvement activities

0

Cost

70.6

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: miyokogreen@occllc.allscriptsdirect.net

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.

• Orthopedic Centers of Colorado, LLC

  • Orthopaedic Surgery Physician
  • Denver, CO
  • NPI 1801339502

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Orthopedic Centers of Colorado, LLC

  • Orthopaedic Surgery Physician
  • Superior, CO
  • NPI 1336870856

  Physician Assistant

  NPD

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

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1295431765
  Care Compare affiliation

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1063853893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2446 RESEARCH PKWY",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201087",
            "telephone_number": "719-623-1050",
            "fax_number": "719-623-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2446 RESEARCH PKWY",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809201087",
            "telephone_number": "719-623-1050",
            "fax_number": "719-623-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MIYOKO",
        "middle_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA0003732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04927729",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIYOKO",
            "last_name": "IVIS",
            "middle_name": "G.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Michael Green, CNIM
• Josette Green
• Keith Green, MSW
• Kendra Linette Green, FNP-C
• Kyle Green, PSY.D.
• Nadia Green
• Nevaeh Green
• Richard J. Green, BC-HIS
• Sarah Green
• Savannah Green, PT

• Physician Assistant in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.