Active NPI
Tanner James Green
- Physician Assistant
- Simi Valley, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 60441
- Practice address
- 2975 Sycamore Dr
Simi Valley, CA 93065-1201 - Phone
- (805) 955-6107
- NPI assigned
- Dec 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 60441 | CA | Primary |
Addresses
Primary practice location
2975 Sycamore Dr
Simi Valley, CA 93065-1201
Mailing address
1203 Flynn Rd Unit 160
Camarillo, CA 93012-6203
Phone (805) 804-4168
Other practice location 1
137 E Thousand Oaks Blvd
Thousand Oaks, CA 91360-5707
Phone (805) 379-4574
Other practice location 2
2525 Erringer Rd
Simi Valley, CA 93065-2352
Phone (805) 527-1404
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- 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: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2525 Erringer Rd
Simi Valley, CA 93065-2352
Phone (805) 527-1404
2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone (805) 955-6000
4949 Market St
Ventura, CA 93003-7851
Phone (877) 608-0044
5601 De Soto Ave
Woodland Hills, CA 91367-6701
Phone (818) 719-2000
888 S Hill Rd
Ventura, CA 93003-8400
Phone (805) 477-6400
Hospital & facility affiliations
- Adventist Health Simi Valley
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.69 of 100
- Quality
- 90
- Improvement activities
- 40
- Cost
- 78.43
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.94 of 100
- Quality
- 73.38
- Improvement activities
- 40
- Cost
- 72.82
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60441 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Cep America - California | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
751 Medical Center Ct
#1182
Chula Vista, CA 91911
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235
15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051
888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400
5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000
Organizations & group practices 8
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Emergency Medicine Physician
- Simi Valley, CA
- NPI 1023773587
-
- Specialist
- Ventura, CA
- NPI 1871547315
-
- Emergency Medical Services (Emergency Medicine) Physician
- Simi Valley, CA
- NPI 1043531346
-
- Emergency Medicine Physician
- Santa Ana, CA
- NPI 1548667843
-
- Emergency Medicine Physician
- Santa Monica, CA
- NPI 1063081545
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Woodland Hills, CA
- NPI 1952333478
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Simi Valley, CA
- NPI 1063495190
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774569600000",
"number": "1093473647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1203 FLYNN RD UNIT 160",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930126203",
"telephone_number": "805-804-4168",
"fax_number": "805-830-1177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2975 SYCAMORE DR",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930651201",
"telephone_number": "805-955-6107"
}
],
"practiceLocations": [
{
"address_1": "137 E Thousand Oaks Blvd",
"address_purpose": "LOCATION",
"city": "Thousand Oaks",
"state": "CA",
"postal_code": "913605707",
"country_code": "US",
"telephone_number": "805-379-4574",
"fax_number": "805-379-4324",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2525 Erringer Rd",
"address_purpose": "LOCATION",
"city": "Simi Valley",
"state": "CA",
"postal_code": "930652352",
"country_code": "US",
"telephone_number": "805-527-1404",
"fax_number": "805-527-5246",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "TANNER",
"middle_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-01",
"last_updated": "2026-03-27",
"certification_date": "2026-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "60441",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "13652 Cantara St",
"city": "Panorama City",
"state": "CA",
"country_code": "US",
"postal_code": "914025423",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; 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.