Samuel B. Green, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MP00063500 Issued in NJ

Practice address

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453

Phone

(856) 582-2816

Fax

(856) 582-2712

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
• West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
• Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029

Merit-based Incentive Payment System (MIPS)

Final score

81.15 of 100Reported as group

Quality

62.28

Promoting interoperability

100

Improvement activities

40

Cost

74.89

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sgreen244139@directvirtua.org

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.

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515
  Medicare reassignment Care Compare group NPD (past)
• Prohealth Urgent Care Medicine of New Jersey LLP

  • Emergency Care Clinic/Center
  • Edgewater, NJ
  • NPI 1477927754
  Medicare reassignment
• Virtua Medical Group, PA

  • Orthopaedic Surgery Physician
  • Delran, NJ
  • NPI 1841087988

  Physician Assistant

  NPD
• Virtua Medical Group, PA

  • Foot & Ankle Surgery Podiatrist
  • Marlton, NJ
  • NPI 1902356215
  NPD
• Atlantic Professional Services of New Jersey, P.a.

  • Physician Assistant
  • Stratford, NJ
  • NPI 1932145182
  NPD (past)
• Revive Spine and Pain Center

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Marlton, NJ
  • NPI 1457896003
  NPD (past)
• Abington Emergency Physician Associates PC

  • Emergency Medicine Physician
  • Abington, PA
  • NPI 1659359099
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Virtua - Memorial Hospital Burlington County, Inc.

  • General Acute Care Hospital
  • Mount Holly, NJ
  • NPI 1134125016
  Care Compare affiliation
• Virtua - West Jersey Health System, Inc.

  • General Acute Care Hospital
  • Voorhees, NJ
  • NPI 1528064409
  Care Compare affiliation
• Virtua Our Lady of Lourdes Hospital Inc

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024
  Care Compare affiliation

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1275575433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 HURFFVILLE CROSS KEYS RD",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122453",
            "telephone_number": "856-582-2816",
            "fax_number": "856-582-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SAMUEL",
        "middle_name": "B.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "MP00063500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wesley Giang
• Elaine Gismondi, BA
• David Gold, PT
• Gary Jeffrey Goldberg, LCSW
• Ingrid Gooden
• Jennifer L Greenhalgh, BS
• Tina Groch
• Melvin Saul Gruber, MD
• Marlea F Gruver, MS, LPC
• Bobbiann Gubbei

• Physician Assistant in Turnersville, NJ
• Providers in Turnersville, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.