Active NPI
Justin B. Green, D.P.M.
- Foot & Ankle Surgery Podiatrist
- New Iberia, LA
National Provider Identifier
1124027644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- PD324R
- Practice address
- 2309 E Main St
Suite 201
New Iberia, LA 70560-4046 - Phone
- (337) 364-8878
- Fax
- (337) 364-8380
- NPI assigned
- Jul 18, 2005
- 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 |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PD324R | LA | Primary |
Addresses
Primary practice location
2309 E Main St
Suite 201
New Iberia, LA 70560-4046
Mailing address
2309 E Main St
Suite 201
New Iberia, LA 70560-4046
Phone (337) 560-5543
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1462462 | Medicaid | LA | |
| 2223526 | Other | LA | FIRST HEALTH |
| PD324R | Other | LA | STATE LICENSE # |
| 7714575 | Other | LA | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1611 | TX | MD | Specialist |
| PD324R | LA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Home Foot Care, LLP | Past | Accepting new patients | |
| Lepow Podiatric Medical Associates | Past | Accepting new patients | |
| Lepow Podiatric Medical Associates | Foot & Ankle Surgery | Past | Accepting new patients |
Interoperability endpoints
- justingreendpm@ifs.ssdirect.aprima.com
Organizations & group practices 3
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.
-
- Primary Podiatric Medicine Podiatrist
- Houston, TX
- NPI 1437147634
-
- Podiatrist
- Houston, TX
- NPI 1730228925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124027644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2309 E MAIN ST",
"address_2": "SUITE 201",
"city": "NEW IBERIA",
"state": "LA",
"postal_code": "705604046",
"telephone_number": "337-560-5543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2309 E MAIN ST",
"address_2": "SUITE 201",
"city": "NEW IBERIA",
"state": "LA",
"postal_code": "705604046",
"telephone_number": "337-364-8878",
"fax_number": "337-364-8380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JUSTIN",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "LA",
"license": "PD324R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1462462",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2223526",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE #",
"identifier": "PD324R",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7714575",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Iberia, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.