Active NPI
Damon S Green, PA-C
- Surgical Physician Assistant
- Casper, WY
National Provider Identifier
1376522276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 365
- Practice address
- 1026 East Second St
Casper, WY 82601 - Phone
- (307) 266-4000
- Fax
- (307) 266-4545
- NPI assigned
- Jan 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 365 | WY | Primary |
Addresses
Primary practice location
1026 East Second St
Casper, WY 82601
Mailing address
419 S Washington St
Suite 102
Casper, WY 82601-2951
Phone (307) 577-4220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY, NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060105000508 | WY | Practitioner - Physician Assistant | 1355364308 | Reassigns benefits to 1 organization |
| I20220809003091 | NE | Practitioner - Physician Assistant | 1355364308 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- North Platte Nebraska Hospital Corporation
Practice addresses (Care Compare)
516 W Leota St
Great Plains Health Rheumatology
North Platte, NE 69101-6533
Phone (308) 568-4800
601 W Leota St
North Platte, NE 69101-6525
Hospital & facility affiliations
- Great Plains Health
- Perkins County Health Services
- Community Hospital
- Ogallala Community Hospital
- Decatur Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 365 | WY | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Platte Nebraska Hospital Corporation | Current | Accepting new patients | |
| North Platte Nebraska Hospital Corporation | Past | Accepting new patients |
Locations
611 W Francis St
Ste 200
North Platte, NE 69101
Phone (308) 534-9230
601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288
Interoperability endpoints
- damon.green@direct.wyomingmedicalcenter.org
- dgreen390552@direct.nebraskamed.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 and National Provider Directory roles.
-
- General Acute Care Hospital
- North Platte, NE
- NPI 1700855533
NE
-
- Medical Oncology Physician
- North Platte, NE
- NPI 1134355332
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- North Platte, NE
- NPI 1700855533
Hospital
-
- Clinical Medical Laboratory
- North Platte, NE
- NPI 1902660509
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1376522276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 S WASHINGTON ST",
"address_2": "SUITE 102",
"city": "CASPER",
"state": "WY",
"postal_code": "826012951",
"telephone_number": "307-577-4220",
"fax_number": "370-235-0931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1026 EAST SECOND ST",
"city": "CASPER",
"state": "WY",
"postal_code": "82601",
"telephone_number": "307-266-4000",
"fax_number": "307-266-4545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "DAMON",
"middle_name": "S",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-10",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "WY",
"license": "365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; 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.