Individual provider Active NPI

Benjamin Joseph Green, D.O.

  • Surgery Physician
  • Iowa City, IA
National Provider Identifier
1134431422
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
04689 Issued in IA
Practice address
540 E Jefferson St
Suite 205
Iowa City, IA 52245-2477
Phone
(319) 688-7880
NPI assigned
Jul 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R-8930 IA
Surgery Physician 208600000X 04689 IA Primary

Addresses

Primary practice location

540 E Jefferson St
Suite 205
Iowa City, IA 52245-2477

Mailing address

PO Box 2027
Iowa City, IA 52244-2027
Phone (319) 339-3451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20150707002341 IA Practitioner - General Surgery 6204087547 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington County HospitalGroup PAC ID 2062329931, 39 clinicians

Practice addresses (Care Compare)

400 E Polk St WCHC Specialty Clinic
Ken and Rosemary Hanson Specialty Clinic
Washington, IA 52353-1237
Phone (319) 653-5481

Hospital & facility affiliations

  • Washington County Hospital and Clinics Hospital, Washington, IA, CCN 161344

Merit-based Incentive Payment System (MIPS)

Final score
85.64 of 100Reported as individual
Quality
73.88
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
04689IAMDSurgery Physician
R-8930IAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Hospital Current Accepting new patients
Washington County Hospital Past Accepting new patients

Locations

400 E Polk St
Washington, IA 52353
Phone (319) 653-5481

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/washin-6836dd27
  • Direct secure messaging: bgreen264617@uihcdirect.org

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1134431422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2027",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522442027",
            "telephone_number": "319-339-3451",
            "fax_number": "319-358-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E JEFFERSON ST",
            "address_2": "SUITE 205",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452477",
            "telephone_number": "319-688-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BENJAMIN",
        "middle_name": "JOSEPH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-02",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "R-8930",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "04689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.