Brandon Phillip Green

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

303159 Issued in CA

Practice address

17906 Pioneer Blvd Unit 101-102
Artesia, CA 90701-3972

Phone

(562) 865-2222

NPI assigned

Nov 15, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optimum Care Physical Therapy ServicesGroup PAC ID 1153320239, 6 clinicians

California Rehabilitation and Sports Therapy a California Physical theGroup PAC ID 6709788896, 182 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• California Rehabilitation & Sports Therapy a California Physical Ther

  • Multi-Specialty Clinic/Center
  • Mission Viejo, CA
  • NPI 1386696409
  Medicare reassignment Care Compare group NPD
• Optimum Care Physical Therapy Services

  • Physical Therapy Clinic/Center
  • Artesia, CA
  • NPI 1700215316

  Orthopedic

  Medicare reassignment Care Compare group NPD
• California Rehab & Sports Therapy

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1508540279
  NPD
• California Rehabilitation & Sports Therapy a California Physical Ther

  • Physical Therapist
  • San Juan Capistrano, CA
  • NPI 1497268742
  NPD

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1497464804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28520 WOOD CANYON DR APT 67",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565270",
            "telephone_number": "510-828-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17906 PIONEER BLVD UNIT 101-102",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907013972",
            "telephone_number": "562-865-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRANDON",
        "middle_name": "PHILLIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "303159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Physical Therapist in Artesia, CA
• Providers in Artesia, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.