Yolanda Bacon-Green, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0044617 Issued in FL

Practice address

601 N Flamingo Rd
Suite 306
Pembroke Pines, FL 33028-1015

Phone

(954) 450-0558

NPI assigned

Feb 8, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Yolanda Bacon-Green MD PA

  • Family Medicine Physician
  • Pembroke Pines, FL
  • NPI 1750422317
  NPD (past) Authorized official

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1144361700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268116",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333268116",
            "telephone_number": "954-450-0558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N FLAMINGO RD",
            "address_2": "SUITE 306",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281015",
            "telephone_number": "954-450-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON-GREEN",
        "first_name": "YOLANDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0044617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.