Active NPI
Robert A Green, PHD
- Psychologist
- Hollywood, FL
National Provider Identifier
1467442236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY2864
- Practice address
- 3363 Sheridan St
Ste 209
Hollywood, FL 33021-3664 - Phone
- (954) 961-9339
- Fax
- (954) 966-1857
- NPI assigned
- Oct 24, 2005
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY2864 | FL | Primary |
Addresses
Primary practice location
3363 Sheridan St
Ste 209
Hollywood, FL 33021-3664
Mailing address
3363 Sheridan St
Ste 209
Hollywood, FL 33021-3664
Phone (954) 961-9339
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74283 | Other | FL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1974
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1451 W Cypress Creek Rd
Suite 300
Fort Lauderdale, FL 33309-1953
Phone (954) 655-4789
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY2864 | FL | MD | Psychologist |
Organizations & group practices 1
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": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1467442236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3363 SHERIDAN ST",
"address_2": "STE 209",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330213664",
"telephone_number": "954-961-9339",
"fax_number": "954-966-1857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3363 SHERIDAN ST",
"address_2": "STE 209",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330213664",
"telephone_number": "954-961-9339",
"fax_number": "954-966-1857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "ROBERT",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY2864",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "74283",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.