Mark Green, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

222713 Issued in MA

Practice address

90 Concord Ave
Belmont, MA 02478-4046

Phone

(857) 598-2808

Fax

(857) 598-2864

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 3, 2018 through Dec 3, 2026

Specialty

Psychiatry

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• The Psych Garden LLC

  • Psychologist
  • Belmont, MA
  • NPI 1922578855
  NPD Authorized official

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1407075294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CONCORD AVE",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024784046",
            "telephone_number": "857-598-2808",
            "fax_number": "857-598-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CONCORD AVE",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024784046",
            "telephone_number": "857-598-2808",
            "fax_number": "857-598-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MA",
            "license": "222713",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "MA",
            "license": "222713",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "222713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41035810",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "021927",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Gortych, PH.D.
• Gary L Gottlieb, MD
• Isabela Goulart Gil Choi, DDS
• Andrew T Gouse, MD
• James John Greaney Jr., PHARMD
• Sharon Greenfield, PSY.D.
• Shelly Faith Greenfield, M.D., MPH
• David O Greenleaf, PH.D.
• Allison Gregg
• Leslie Gregory

• Psychiatry Physician in Belmont, MA
• Providers in Belmont, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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; Opt Out Affidavits.
• 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.