NPIMap

Individual provider Active NPI

David E Greene, PA-C

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1336189547
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01120 Issued in OR
Practice address
3011 East Barnette Rd
Medford, OR 97504-8332
Phone
(541) 789-4673
Fax
(541) 789-5678
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01120 OR Primary

Addresses

Primary practice location

3011 East Barnette Rd
Medford, OR 97504-8332

Mailing address

PO Box 4749
Medford, OR 97501-0227
Phone (541) 789-4111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dgreene275639@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060622000105 OR Practitioner - Physician Assistant 2961469788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
AsanteGroup PAC ID 0547177321, 141 clinicians
Asante Three Rivers Medical Center LLCGroup PAC ID 9931197993, 98 clinicians

Practice addresses (Care Compare)

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-7000

500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 472-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA01120ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Asante CurrentSince Feb 23, 2023 Accepting new patients
Asante CurrentSince Feb 23, 2023 Accepting new patients
Asante Physician Partners Past Accepting new patients

Locations

3011 E Barnett Rd
Medford, OR 97504
Phone (541) 789-4673

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

Interoperability endpoints

  • Direct secure messaging: dgreene275639@oc.providencedirect.org

Organizations & group practices 4

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 6

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1336189547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4749",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010227",
            "telephone_number": "541-789-4111",
            "fax_number": "541-789-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 EAST BARNETTE RD",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048332",
            "telephone_number": "541-789-4673",
            "fax_number": "541-789-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "DAVID",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA01120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dgreene275639@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1698 E McAndrews Rd Ste 400",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975045590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.