Individual provider Active NPI

David A. Green, M.D.

  • Urology Physician
  • Glen Ridge, NJ
National Provider Identifier
1245503523
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
262278 Issued in NY
Practice address
777 Bloomfield Ave
Glen Ridge, NJ 07028-2325
Phone
(973) 429-0462
Fax
(973) 429-8765
NPI assigned
Feb 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 262278 NY Primary

Addresses

Primary practice location

777 Bloomfield Ave
Glen Ridge, NJ 07028-2325

Mailing address

375 Mount Pleasant Ave
Suite 250
West Orange, NJ 07052-2750
Phone (973) 323-1320

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address dag9025@direct.nyp.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20120712000504 NY Practitioner - Urology 7618132812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Icahn School of Medicine at Mount Sinai, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York Queens Medicine and Surgery, P.C.Group PAC ID 4082883673, 401 clinicians

Practice addresses (Care Compare)

5645 Main St
Flushing, NY 11355-5045
Phone (718) 670-2000

Hospital & facility affiliations

  • New York-Presbyterian/Queens Hospital, Flushing, NY, CCN 330055
  • The University Hospital Hospital, Newark, NJ, CCN 310119

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
262278NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newyork-Presbyterian-Queens Past Accepting new patients
Weill Medical College of Cornell Urology Past Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1245503523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 MOUNT PLEASANT AVE",
            "address_2": "SUITE 250",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522750",
            "telephone_number": "973-323-1320",
            "fax_number": "973-323-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BLOOMFIELD AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070282325",
            "telephone_number": "973-429-0462",
            "fax_number": "973-429-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DAVID",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-16",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "262278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "7568 187th St Fl 2",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113661726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "7568 187th St Fl 2",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113661726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dag9025@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "7568 187th St Fl 2",
            "city": "Fresh Meadows",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113661726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glen Ridge, NJ

Sources for this page

Verify at the official NPI Registry.