Jeremy Blair Green, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME107541 Issued in FL

Practice address

4425 Ponce de Leon Blvd
Suite 200
Coral Gables, FL 33146-1837

Phone

(305) 443-6606

Fax

(305) 443-4890

NPI assigned

May 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Dermatology

Education

University of Miami, LM Miller School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skin Associates of South Florida PAGroup PAC ID 0749599793, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Skin Associates of South Florida, P.a.

  • Dermatology Physician
  • Coral Gables, FL
  • NPI 1801283122
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1225249055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 PONCE DE LEON BLVD",
            "address_2": "SUITE 200",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461837",
            "telephone_number": "305-443-6606",
            "fax_number": "305-443-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 PONCE DE LEON BLVD",
            "address_2": "SUITE 200",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461837",
            "telephone_number": "305-443-6606",
            "fax_number": "305-443-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JEREMY",
        "middle_name": "BLAIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME107541",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME107541",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Christina Gravier, SLPA
• Gravitas Health LLC
• Steven Gray
• Greater Florida Emergency Group LLC
• Green Hope Pharmacy Inc
• Kryn Micheal Green, CRNA, ARNP
• Mae Sylvia Greenberg, LMHC
• Yitzhak Greenberg
• Greenewell LLC
• Larisse Duarte Greenwell

• Dermatology Physician in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; 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.