Individual provider Active NPI

Michael B Green, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1457388357
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD061635L Issued in PA
Practice address
700 Spruce Street
Suite 304
Philadelphia, PA 19106
Phone
(215) 829-3510
Fax
(215) 829-7129
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD061635L PA Primary

Addresses

Primary practice location

700 Spruce Street
Suite 304
Philadelphia, PA 19106

Mailing address

700 Spruce St
Suite 304
Philadelphia, PA 19106-4022
Phone (215) 829-3510

Other identifiers 1

IdentifierTypeStateIssuer
0016518670003MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20091006000251 PA Practitioner - HospitalistPractitioner - Internal Medicine 3375689300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Perelman School of Med at the University of Pennsylvania, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

800 Spruce St FL 1 Pine W
Hospital Medicine Pah
Philadelphia, PA 19107-6130
Phone (215) 829-7817

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Syst Internal Medicine CurrentSince Aug 14, 2001 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 14, 2001 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

700 Spruce St
Ste 304
Philadelphia, PA 19106
Phone (215) 829-3521

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1457388357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SPRUCE ST",
            "address_2": "SUITE 304",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064022",
            "telephone_number": "215-829-3510",
            "fax_number": "215-829-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SPRUCE STREET",
            "address_2": "SUITE 304",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19106",
            "telephone_number": "215-829-3510",
            "fax_number": "215-829-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD061635L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016518670003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.