Dora Renee Green, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Port Matilda, PA
NPI 1245217124 · NPPES record last updated Mar 9, 2026
Key facts
- NPI
- 1245217124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- RN264780 (PA)
- Practice address
- 132 Abigail LN
Port Matilda, PA 16870-7153 - Phone
- (814) 272-5011
- Fax
- (814) 272-6531
- NPI assigned
- Dec 30, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kings Daughters Medical Specialties Inc
Covenant Anesthesia Group PC
Practice addresses (Care Compare)
1901 Argonne Rd
Portsmouth, OH 45662-2827
Phone (740) 353-1978
990 Oak Ridge Tpke
Oak Ridge, TN 37830-6976
Phone (865) 835-3560
Hospital & facility affiliations
- Kings Daughters Medical Center Ohio
- Methodist Medical Center of Oak Ridge
Merit-based Incentive Payment System (MIPS)
- Final score
- 73.64 of 100
- Quality
- 56.63
- Improvement activities
- 40
- Cost
- 74.98
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (4 enrollments) in OH, VA, KY, TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111202000653 | OH | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2961677927 | Reassigns benefits to 3 organizations |
| I20220225000007 | VA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2961677927 | Reassigns benefits to 1 organization |
| I20241011000264 | KY | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2961677927 | Reassigns benefits to 1 organization |
| I20250820000327 | TN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2961677927 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN264780 | PA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Claire Medical Center, Inc., | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| St Claire Medical Center, Inc | Current |
Accepting new patients | |
| American Anesthesiology of Virginia, PC | Current |
Accepting new patients | |
| St. Claire Medical Center Inc. | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Kings Daughters Medical Specialties Inc | Current | Accepting new patients | |
| Outpatient Anesthesia Specialists | Current |
Accepting new patients | |
| Kings Daughters Medical Specialties Inc | Current |
Accepting new patients | |
| Covenant Anesthesia Group, PC | Current |
Accepting new patients | |
| Kings Daughters Medical Specialties Inc | Current |
Accepting new patients | |
| American Anesthesiology of Virginia PC | Current |
Accepting new patients |
Locations
222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455
4700 Smith Rd
Norwood, OH 45212
Phone (513) 366-3400
2000 Joseph E Sanker Blvd
Norwood, OH 45212
Phone (513) 841-7400
1901 Argonne Rd
Portsmouth, OH 45662
Phone (740) 991-0911
1242 Crescent Dr
Wheelersburg, OH 45694
Phone (740) 574-8441
Dept 888089
Knoxville, TN 37995
990 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 481-1000
19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950
1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN264780 | PA | Yes |
Addresses
Primary practice location
132 Abigail LN
Port Matilda, PA 16870-7153
Mailing address
100 N Academy Ave Ste 6&7
Danville, PA 17822-4903
Phone (814) 272-5011
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2247661 | Medicaid | OH | |
| 728022 | Other | BUCKEYE | |
| 74006495 | Medicaid | KY | |
| 000001092366 | Other | IN | ANTHEM PROVIDER NUMBER |
| 000000196948 | Other | ANTHEM BLUE SHIELD | |
| 300004136 | Medicaid | IN | |
| 617576 | Other | KY | WELLCARE |
| 200371350 | Medicaid | IN |
Other providers in Port Matilda, PA
- Geisinger Clinic
- Geisinger Lewistown Hospital
- Geisinger Lewistown Hospital
- Shaheen M. Gill
- Rana Y Glick
- Jerah Gregory Griggs
- Joanna Martin Gunnett
- Stephanie Rebecca Hanlon
- Evan James Harlor
- Kayla Lynn Hawbaker
All providers in Port Matilda, PA · Certified Registered Nurse Anesthetist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.