Bridget Anne Green, M.D,

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

4301083630 Issued in MI

Practice address

6150 Northland Drive
Rockford, MI 49341

Phone

(616) 942-9343

Fax

(616) 942-2538

NPI assigned

May 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Dermatology

Education

Michigan State University College of Human Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jack a Dekkinga MD PCGroup PAC ID 3375538432, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Jack a Dekkinga MD PC

  • Dermatology Physician
  • Grandville, MI
  • NPI 1609896034
  Medicare reassignment Care Compare group NPD
• Northwestern Michigan Dermatology

  • MOHS-Micrographic Surgery Physician
  • Traverse City, MI
  • NPI 1346457488
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1356542500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 NORTHLAND DRIVE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "49341",
            "telephone_number": "616-942-9343",
            "fax_number": "616-942-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 NORTHLAND DRIVE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "49341",
            "telephone_number": "616-942-9343",
            "fax_number": "616-942-2538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3434 Rivertown Point Ct SW",
            "address_purpose": "LOCATION",
            "city": "Grandville",
            "state": "MI",
            "postal_code": "494183076",
            "country_code": "US",
            "telephone_number": "616-257-3344",
            "fax_number": "616-257-1491",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3290 N Wellness Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494247261",
            "country_code": "US",
            "telephone_number": "616-395-9379",
            "fax_number": "616-820-1457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRIDGET",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301083630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2166108",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Elizabeth Godleski
• Stephanie Diana Gomez, BCBA, LBA
• Melanie Marie Graham
• Deborah Ann Granger, PHYSICAL THERAPIST
• William Charles Granger, M.D.
• Charles J Greengoss
• Greenrock Springs Urgent Family Care PC
• Elizabeth Griffith
• Laura Grimm, DC
• Hannah Grissom, LMT

• Dermatology Physician in Rockford, MI
• Providers in Rockford, MI by specialty
• Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.