Individual provider Active NPI

Michael D. Green, MD

  • Diagnostic Radiology Physician
  • Englewood, NJ
National Provider Identifier
1447359054
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
120848-1 Issued in NY
Practice address
380 Kenwood St
Englewood, NJ 07631-5118
Phone
(201) 602-4444
NPI assigned
Sep 21, 2006
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA03795000 NJ
Diagnostic Radiology Physician 2085R0202X 120848-1 NY Primary

Addresses

Primary practice location

380 Kenwood St
Englewood, NJ 07631-5118

Mailing address

380 Kenwood St
Englewood, NJ 07631-5118
Phone (201) 602-4444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040621001455 NJ Practitioner - Diagnostic Radiology 6709771454 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03795000NJMDDiagnostic Radiology Physician
120848-1NYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Burlington Diagnostic Imaging LLC Multi-Specialty CurrentSince Jan 23, 2021 Accepting new patients
Progressive Diagnostic Imaging, LLC Diagnostic Radiology CurrentSince Jan 1, 2018 Accepting new patients
Adirondack Diagnostic Imaging Inc. Multi-Specialty Current Accepting new patients
Mercer Diagnostic Imaging, LLC Multi-Specialty CurrentSince May 27, 2020 Accepting new patients
Open MRI of Naples, Inc. Multi-Specialty PastSince Feb 1, 2011 Accepting new patients
Adirondack Diagnostic Imaging of Albany Multi-Specialty PastSince Apr 30, 2003 Accepting new patients
Capital Region Open MRI, Inc Multi-Specialty PastSince Aug 22, 2010 Accepting new patients
Hudson MRI PA Multi-Specialty PastSince Jan 1, 2017 Accepting new patients
The New Jersey Imaging Network, LLC Multi-Specialty Past Accepting new patients

Locations

2800 Route 130 N
Ste 202
Cinnaminson, NJ 08077
Phone (856) 210-7666

44 State Rt 23
Riverdale, NJ 07457
Phone (973) 839-5004

1245 Whitehorse Mercerville Rd
Ste 403
Trenton, NJ 08619
Phone (609) 581-2727

3 Emma Ln
Clifton Park, NY 12065
Phone (518) 278-4334

632 Plank Rd
Ste 103
Clifton Park, NY 12065
Phone (518) 414-5706

Organizations & group practices 9

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1447359054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 KENWOOD ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076315118",
            "telephone_number": "201-602-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 KENWOOD ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076315118",
            "telephone_number": "201-602-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA03795000",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "120848-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.