Geoffrey Riley Green, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17453 Issued in CA

Practice address

1100 West Stewart Drive
Orange, CA 92868-3849

Phone

(714) 633-9111

NPI assigned

Jul 7, 2006

Last updated

Jan 13, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Specialists of Orange County

  • Emergency Medicine Physician
  • Orange, CA
  • NPI 1740214733
  Medicare reassignment
• James E. Pierog, MD, Inc.

  dba Orange Health and Wellness

  • Urgent Care Clinic/Center
  • Orange, CA
  • NPI 1134432453
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1306878533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908010690",
            "telephone_number": "562-809-3547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WEST STEWART DRIVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683849",
            "telephone_number": "714-633-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "GEOFFREY",
        "middle_name": "RILEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA17453",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Green Haven Home Care
• Ambar Jacqueline Green
• Brittney Green
• Emelie Green
• Eric Anthony Green
• Jessica Michelle Green, MD
• Lisette Florencia Green
• Makenna Katherine Green
• Sandra Lucille Green
• Danielle Greenberg, MD

• Medical Physician Assistant in Orange, CA
• Providers in Orange, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.