Shea Elizabeth Green, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8239 Issued in AZ

Practice address

8752 E Via de Commercio Ste 1
Scottsdale, AZ 85258-3396

Phone

(480) 684-1080

Fax

(480) 684-1081

NPI assigned

Apr 10, 2020

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Priority Family Medical Clinic LLCGroup PAC ID 1850632019, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shea.green@1028.chartlogic.direct-ci.com

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.

• Priority Family Medical Clinic LLC

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1205309812

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Palo Verde Hematology Oncology LTD.

  • Hematology & Oncology Physician
  • Glendale, AZ
  • NPI 1447272372

  Single Specialty

  Medicare reassignment NPD
• Cep America- Arizona, PC

  • Emergency Medicine Physician
  • Chandler, AZ
  • NPI 1780202804
  Medicare reassignment
• Progressive Medical Associates PLLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1548218613
  Medicare reassignment

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

• Yavapai Community Hospital Association

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1164041034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9097 E DESERT COVE AVE STE 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606280",
            "telephone_number": "480-273-8510",
            "fax_number": "480-214-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8752 E VIA DE COMMERCIO STE 1",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583396",
            "telephone_number": "480-684-1080",
            "fax_number": "480-684-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SHEA",
        "middle_name": "ELIZABETH",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085142",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derek Green, DMD
• Destiny Green
• Emily Green, COTA/L
• Heidi Green, PSY.D.
• John R. Green, M.D.
• Alan Leblang Greenbaum, PH.D.
• Stuart L Greenberg, O.D.
• Victoria Lynn Greenberg, RPH
• Jeffrey Bryan Greene, D.D.S.
• Lindsey Greene, PA-C

• Physician Assistant in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.