NPIMap

Individual provider Active NPI

Christopher Selby Green, MD

  • Vascular & Interventional Radiology Physician
  • Tacoma, WA
National Provider Identifier
1205196607
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
MD60721597 Issued in WA
Practice address
1304 Fawcett Ave Ste 100
Tacoma, WA 98402
Phone
(253) 761-4200
Fax
(253) 761-4201
NPI assigned
May 21, 2012
Last updated
Mar 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD60721597 WA
Diagnostic Radiology Physician 2085R0202X MD191346 OR
Vascular & Interventional Radiology Physician 2085R0204X MD191346 OR
Vascular & Interventional Radiology Physician 2085R0204X MD60721597 WA Primary

Addresses

Primary practice location

1304 Fawcett Ave Ste 100
Tacoma, WA 98402

Mailing address

PO Box 1535
Tacoma, WA 98401-1535
Phone (253) 761-4200

Other practice location 1

2502 S Union Ave
Tacoma, WA 98405-1328
Phone (253) 761-9482

Other practice location 2

222 15th Ave SE
Puyallup, WA 98372-3754
Phone (253) 841-4353

Other identifiers 5

IdentifierTypeStateIssuer
0388746OtherWALNI-DINW
0388739OtherWALNI-TRA REST OF WA
0388744OtherWALNI-TRA KING COUNTY
0388745OtherWALNI-UAOM
2047933MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NC, AK3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180521002773 WA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 1153634241 Reassigns benefits to 3 organizations
I20200305002394 NC Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 1153634241 Reassigns benefits to 1 organization
I20220505002438 AK Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 1153634241 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of California, Irvine, California College of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mt Baker Imaging LLCGroup PAC ID 7113963802, 34 clinicians
Northwest Radiologists Inc PSGroup PAC ID 1456248368, 27 clinicians
PeacehealthGroup PAC ID 9436067618, shared by 5 NPIs, 71 clinicians

Practice addresses (Care Compare)

2930 Squalicum Pkwy
Suite 101
Bellingham, WA 98225-1854
Phone (360) 733-0430

3100 Tongass Ave
Ketchikan, AK 99901-5746
Phone (360) 733-0430

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
85.63
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
62 of 100Reported as group
Quality
80
Improvement activities
40
Cost
10

Merit-based Incentive Payment System (MIPS)

Final score
79.12 of 100Reported as group
Quality
81.91
Promoting interoperability
100
Improvement activities
40
Cost
40.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60721597WAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Radiologists Inc PS Diagnostic Radiology CurrentSince Jun 7, 2022 Accepting new patients
Diagnostic Radiology & Imaging LLC Diagnostic Radiology CurrentSince Feb 1, 2020 Accepting new patients
Mt. Baker Imaging LLC Diagnostic Radiology CurrentSince Jun 7, 2022 Accepting new patients
Pinnacle Health Services of North Carolina, LLC Diagnostic Radiology CurrentSince Jun 6, 2022 Accepting new patients
Peacehealth Current Accepting new patients
Pinnacle Health Services of North Carolina LLC Diagnostic Radiology CurrentSince Oct 6, 2020 Accepting new patients
Pinnacle Health Services of North Carolina, LLC Diagnostic Radiology CurrentSince Oct 7, 2020 Accepting new patients
Brier Creek Imaging, LLC Diagnostic Radiology CurrentSince Oct 5, 2020 Accepting new patients
Peacehealth Diagnostic Radiology CurrentSince Jun 1, 2022 Accepting new patients
Greensboro Radiology, PA Diagnostic Radiology CurrentSince Jan 1, 2020 Accepting new patients
Tra-Minw P S Past Accepting new patients

Locations

3100 Tongass Ave
Ketchikan, AK 99901
Phone (907) 225-4104

375 Sunset Ave
Asheboro, NC 27203
Phone (336) 625-4215

1331 N Elm St
Ste 200
Greensboro, NC 27401
Phone (336) 274-4285

315 W Wendover Ave
Greensboro, NC 27408
Phone (336) 273-0530

1814 Westchester Dr
Ste 100
High Point, NC 27262
Phone (336) 802-2397

2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400

2930 Squalicum Pkwy
Ste 101
Bellingham, WA 98225
Phone (360) 733-0890

2930 Squalicum Pkwy
Ste 201
Bellingham, WA 98225
Phone (360) 733-3177

4029 Northwest Ave
Ste 201
Bellingham, WA 98226

Interoperability endpoints

  • Direct secure messaging: cgreen554094@direct.peacehealth.org

Organizations & group practices 11

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.

Hospital & facility affiliations 6

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": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1205196607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1535",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984011535",
            "telephone_number": "253-761-4200",
            "fax_number": "253-383-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 FAWCETT AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98402",
            "telephone_number": "253-761-4200",
            "fax_number": "253-761-4201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2502 S Union Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984051328",
            "country_code": "US",
            "telephone_number": "253-761-9482",
            "fax_number": "253-759-6252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 15th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983723754",
            "country_code": "US",
            "telephone_number": "253-841-4353",
            "fax_number": "253-583-8630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "SELBY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-21",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60721597",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OR",
            "license": "MD191346",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OR",
            "license": "MD191346",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "MD60721597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-DINW",
            "identifier": "0388746",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-TRA REST OF WA",
            "identifier": "0388739",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-TRA KING COUNTY",
            "identifier": "0388744",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI-UAOM",
            "identifier": "0388745",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2047933",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.