Charles Alexandre Greener, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

2141 N Harbor Blvd Ste 35000
Fullerton, CA 92835-3831

Phone

(714) 626-8657

Fax

(714) 626-8686

NPI assigned

Oct 23, 2018

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 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

Locations

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.

• Enloe Medical Center

  • Surgery Physician
  • Chico, CA
  • NPI 1992117592
  Medicare reassignment NPD
• Sinu-Clear Inc

  • Otolaryngology Physician
  • Encino, CA
  • NPI 1831298751
  Medicare reassignment
• Enloe Medical Center

  • Community/Retail Pharmacy
  • Chico, CA
  • NPI 1912949538
  NPD

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1346716842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 THE MEWS SOUTH 7TH ST",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342629",
            "telephone_number": "224-523-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 N HARBOR BLVD STE 35000",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353831",
            "telephone_number": "714-626-8657",
            "fax_number": "714-626-8686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 The Mews Seventh Street",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601346013",
            "country_code": "US",
            "telephone_number": "224-523-2913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENER",
        "first_name": "CHARLES",
        "middle_name": "ALEXANDRE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-23",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Green, M.S., CCC-SLP
• Tiffany Nicole Green, LICENSED MARRIAGE AN
• Brian Greene
• Ciera Greene
• Rachel Lynne Greene
• Greenfield Care Center of Fullerton, LLC
• Lauryn Taylor Gregorec
• Jesus Eduardo Gregorio
• Gregory Alan Kubo, O.D., Apc
• Gregory J Valentine a C P C

• Surgical Physician Assistant in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.