Individual provider Active NPI

Ashley Evelyn Green, MD

  • Pediatrics Physician
  • Rochester, MN
National Provider Identifier
1194294439
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
69815 Issued in MN
Practice address
210 9TH St SE
Rochester, MN 55904-6756
Phone
(507) 288-3443
NPI assigned
Nov 15, 2018
Last updated
Jul 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 69815 MN Primary

Addresses

Primary practice location

210 9TH St SE
Rochester, MN 55904-6756

Mailing address

210 9TH St SE
Rochester, MN 55904-6756
Phone (507) 288-3443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20210802000423 MN Practitioner - Pediatric Medicine 9739583543 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care CurrentSince Oct 14, 2022 Accepting new patients
Fairview Clinics CurrentSince Oct 14, 2022 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Oct 14, 2022 Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 14, 2022 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Oct 14, 2022 Accepting new patients
Fairview Health Services CurrentSince Oct 14, 2022 Accepting new patients
Fairview Health Services CurrentSince Oct 14, 2022 Accepting new patients
Fairview Express Care CurrentSince Oct 14, 2022 Accepting new patients
Healtheast Medical Research Institute Past Accepting new patients
Healtheast Woodwinds Hospital Past Accepting new patients
Healtheast St. John's Hospital Past Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2450 Riverside Ave
Rm M136
Minneapolis, MN 55454
Phone (612) 624-4418

2450 Riverside Ave
Rm M1361
Minneapolis, MN 55454

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1875 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1194294439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 9TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046756",
            "telephone_number": "507-288-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 9TH ST SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046756",
            "telephone_number": "507-288-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ASHLEY",
        "middle_name": "EVELYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "69815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.