Gary Alan Green, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G63969 Issued in CA

Practice address

881 Alma Real Dr Ste 101
Pacific Palisades, CA 90272-3792

Phone

(310) 829-8923

Fax

(424) 212-5936

NPI assigned

Jul 26, 2006

Last updated

Feb 13, 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Family Practice

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
• Saint John's Health Center Hospital, Santa Monica, CA, CCN 050290
• Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Merit-based Incentive Payment System (MIPS)

Final score

90.42 of 100Reported as group

Quality

96.07

Promoting interoperability

100

Improvement activities

40

Cost

71.98

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ggreen595738@oc.providencedirect.org

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.

• Providence Saint Johns Medical Foundation

  dba Saint John's Physician Partners

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Pacific Palisades Medical Group Inc.

  • Family Medicine Physician
  • Pacific Palisades, CA
  • NPI 1215037049
  Medicare reassignment
• Providence Saint Johns Medical Foundation

  dba One Medical

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1518438712
  NPD
• Saint John's Health Clinic

  dba Providence Saint John's Health Clinic

  • Specialist
  • Santa Monica, CA
  • NPI 1336438902
  NPD (past)
• UCLA Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1043427248

  Family Medicine

  NPD (past)

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

• Providence Saint John's Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  Care Compare affiliation
• Regents of the Univ of California

  dba Santa MonicaUCLAMC and Orthopedic Hospital

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1427055839
  Care Compare affiliation
• Regents Univ of Calif Los Angeles

  dba Ronald Reagan UCLA Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1902803315
  Care Compare affiliation

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1154345254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 ALMA REAL DR STE 101",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723792",
            "telephone_number": "310-829-8923",
            "fax_number": "424-212-5936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 ALMA REAL DR STE 101",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723792",
            "telephone_number": "310-829-8923",
            "fax_number": "424-212-5936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15200 W Sunset Blvd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Pacific Palisades",
            "state": "CA",
            "postal_code": "902723620",
            "country_code": "US",
            "telephone_number": "310-459-7736",
            "fax_number": "310-230-0284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "GARY",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G63969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G639690",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ggreen595738@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "881 Alma Real Dr Ste 101",
            "city": "Pacific Palisades",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902723792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ronna Goore, MS, CCC-SLP
• Alexander Scranton Gordon I, LMFT
• Carol Ann Gordon, BSC OT
• Lynn Goren, PHD.
• Julie Caroline Graham
• Gweneth Grigsby, LMFT
• Rafael Gurvis, DDS
• Elizabeth Ann Halliday, PHD
• Marcella B. Hardart, MD
• Joseph A Hardwick, M.D.

• Internal Medicine Physician in Pacific Palisades, CA
• Providers in Pacific Palisades, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.