Active NPI
John A Green III, MD
- General Practice Physician
- Santa Fe, NM
National Provider Identifier
1306997499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- MD12292
- Practice address
- 3 Juego CT
Santa Fe, NM 87508 - Phone
- (503) 722-4270
- Fax
- (503) 722-4450
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | MD12292 | OR | Primary |
Addresses
Primary practice location
3 Juego CT
Santa Fe, NM 87508
Mailing address
3 Juego CT
Santa Fe, NM 87508
Phone (503) 722-4270
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 21, 2018 through Mar 21, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD12292 | OR | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1306997499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 JUEGO CT",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87508",
"telephone_number": "503-722-4270",
"fax_number": "503-722-4450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 JUEGO CT",
"city": "SANTA FE",
"state": "NM",
"postal_code": "87508",
"telephone_number": "503-722-4270",
"fax_number": "503-722-4450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "JOHN",
"middle_name": "A",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-15",
"last_updated": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "OR",
"license": "MD12292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.