Justin Green

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4568 Issued in SD

Practice address

3917 West Rd Ste a
Los Alamos, NM 87544-2292

Phone

(505) 661-8900

NPI assigned

Jun 5, 2006

Last updated

Sep 27, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NM

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

General Surgery

Education

University of Kansas School of Med (KC/Wich/Sal), 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Associates of Northern New MexicoGroup PAC ID 1557354339, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Los Alamos Medical Center Hospital, Los Alamos, NM, CCN 320033
• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gev6437@yourcarecommunity.org
• FHIR API: https://fhir4.healow.com/fhir/r4/AAGADA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Associates of Northern New Mexico

  • Cardiovascular Disease Physician
  • Los Alamos, NM
  • NPI 1073501508
  Medicare reassignment Care Compare group NPD
• Los Alamos Physician Practices LLC

  • Family Medicine Physician
  • Los Alamos, NM
  • NPI 1750330510
  Medicare reassignment NPD
• Los Alamos Physician Practices, LLC

  dba Los Alamos General Surgery Clinic

  • Surgery Physician
  • Los Alamos, NM
  • NPI 1801075783
  NPD
• Rapid City Indian Health Service Hospital

  • General Acute Care Hospital
  • Rapid City, SD
  • NPI 1316900327
  NPD (past)

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

• PHC-Los Alamos Inc

  dba Los Alamos Medical Center

  • Rural Acute Care Hospital
  • Los Alamos, NM
  • NPI 1285701623
  Care Compare affiliation
• St Vincent Hospital

  dba CHRISTUS St. Vincent Regional Medical Center

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1114966462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 WEST RD",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442275",
            "telephone_number": "505-661-8900",
            "fax_number": "505-661-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST RD STE A",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442292",
            "telephone_number": "505-661-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "4568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn Marie Gonzales
• Naomi Rae Gonzales
• Gonzalo a Diaz (Los Alamos)
• Patrice E Goodkind, MSW, LISW
• Brenna Graham
• Greg Baca MD, LLC
• Ronnie James Griego
• Mary Grow
• Susan L Grubb, D.O.M.
• Brian James Haigh, M.D.

• Surgery Physician in Los Alamos, NM
• Providers in Los Alamos, NM by specialty
• Surgery Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.