Individual provider Active NPI

David C Green, M.D.

  • Otolaryngology Physician
  • Burien, WA
National Provider Identifier
1356351886
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD00027977 Issued in WA
Practice address
16259 Sylvester Rd SW Ste 504
Burien, WA 98166-3059
Phone
(206) 242-3696
Fax
(206) 246-1078
NPI assigned
Aug 8, 2006
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD00027977 WA Primary

Addresses

Primary practice location

16259 Sylvester Rd SW Ste 504
Burien, WA 98166-3059

Mailing address

16259 Sylvester Rd SW Ste 504
Burien, WA 98166-3059
Phone (206) 242-3696

Other identifiers 1

IdentifierTypeStateIssuer
1056338MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080214000497 WA Practitioner - Otolaryngology 3375531338 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00027977WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jan 1, 2008 Accepting new patients
Proliance Surgeons Inc., P.S. CurrentSince Jan 1, 2008 Accepting new patients

Locations

16122 8th Ave SW
Ste D1
Burien, WA 98166
Phone (206) 241-7146

16259 Sylvester Rd SW
Ste 504
Burien, WA 98166
Phone (206) 242-3696

16259 Sylvester Rd SW
Ste 505
Burien, WA 98166
Phone (206) 242-3696

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: david.green.p47@direct.proliance.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1356351886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16259 SYLVESTER RD SW STE 504",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663059",
            "telephone_number": "206-242-3696",
            "fax_number": "206-246-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16259 SYLVESTER RD SW STE 504",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663059",
            "telephone_number": "206-242-3696",
            "fax_number": "206-246-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DAVID",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00027977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1056338",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.