Philip A Green, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD00041990 Issued in WA

Practice address

401 W Poplar St
Psmmc ER
Walla Walla, WA 99362-2846

Phone

(509) 522-5802

Fax

(509) 522-5541

NPI assigned

Jun 9, 2006

Sex

Male

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 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Emergency Medicine

Education

University of Washington School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pgreen299266@wm.providencedirect.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.

• Providence Health & Services - Washington

  dba Providence Medical Group Southeast Washington

  • Family Medicine Physician
  • Walla Walla, WA
  • NPI 1922259738
  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Washington

  dba Providence Medical Group Southeast Washington Imaging

  • Diagnostic Radiology Physician
  • Walla Walla, WA
  • NPI 1306097126
  NPD
• Lewis County Emergency Physicians

  • Emergency Medicine Physician
  • Centralia, WA
  • NPI 1174555684
  NPD (past)
• Olympia Emergency Services, PLLC

  • Emergency Medicine Physician
  • Olympia, WA
  • NPI 1346267796
  NPD (past)

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

• Providence Health & Services - Washington

  dba Providence St Mary Medical Center

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  Care Compare affiliation

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1104867373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34439",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W POPLAR ST",
            "address_2": "PSMMC ER",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622846",
            "telephone_number": "509-522-5802",
            "fax_number": "509-522-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "PHILIP",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00041990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000139",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104867373",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pgreen299266@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "401 W Poplar St",
            "address_2": "PSMMC ER",
            "city": "Walla Walla",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993622846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nannette D Goyer
• Jon Granbois
• Camille Denise Granitz, MS CCC SLP
• Grapevine Radiology Associates
• Lauren Sue Graybill, OTR/L, CLT
• Tamey Greene, LMHCA
• Sherri Lynn Greenwald, RN
• Michael D Gregg, M.S.P.T.
• Rebecca Louise Grenard, RPH
• Derek Grieb

• Emergency Medicine Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Emergency Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.
• 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.