Individual provider Active NPI

Greta Denise Green, CNP

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1336220482
Registry record updated Jul 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20684 Issued in CA
Practice address
150 N Reno St
Los Angeles, CA 90026-4656
Phone
(213) 380-7298
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20684 CA Primary

Addresses

Primary practice location

150 N Reno St
Los Angeles, CA 90026-4656

Mailing address

150 N Reno St
Los Angeles, CA 90026-4656
Phone (213) 380-7298

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150317002801 CA Practitioner - Nurse Practitioner 9739281726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventist Health Physicians Network 628 clinicians

Practice addresses (Care Compare)

124 Macaw LN
Simi Valley, CA 93065-3152
Phone (805) 306-0304

2950 Sycamore Dr
Simi Valley, CA 93065-1210

Hospital & facility affiliations

  • Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12200TNMDPhysical Therapist
20684CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Apr 1, 2024 Accepting new patients
Adventist Health Physicians Network CurrentSince Apr 1, 2024 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients

Locations

124 Macaw Ln
Simi Valley, CA 93065
Phone (805) 306-0304

Interoperability endpoints

  • Direct secure messaging: greta.green@398008301912068.direct.elationemr.com
  • Direct secure messaging: greta.green.p1@direct.lakeside.nextgenshare.com

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 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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404432000000",
    "number": "1336220482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N RENO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264656",
            "telephone_number": "213-380-7298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N RENO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900264656",
            "telephone_number": "213-380-7298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "GRETA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "20684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.