Individual provider Active NPI

Hannah Green, M.D.

  • Family Medicine Physician
  • El Cajon, CA
National Provider Identifier
1265966006
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A15870 Issued in CA
Practice address
855 E Madison Ave
El Cajon, CA 92020-3819
Phone
(619) 440-2751
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A15870 CA Primary

Addresses

Primary practice location

855 E Madison Ave
El Cajon, CA 92020-3819

Mailing address

855 E Madison Ave
El Cajon, CA 92020-3819
Phone (619) 440-2751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200817002108 CA Practitioner - Family Practice 8628494051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neighborhood HealthcareGroup PAC ID 5294649406, 153 clinicians

Practice addresses (Care Compare)

855 E Madison Ave
El Cajon, CA 92020-3819
Phone (619) 440-2751

Hospital & facility affiliations

  • Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A15870CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Healthcare General Practice Past Accepting new patients

Organizations & group practices 2

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 1

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": "1492560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1265966006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 E MADISON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203819",
            "telephone_number": "619-440-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 E MADISON AVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203819",
            "telephone_number": "619-440-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "HANNAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-19",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A15870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.