Madison Green, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61222553 Issued in WA

Practice address

1519 3Rd St SE
Puyallup, WA 98372-3742

Phone

(253) 841-8939

NPI assigned

Jan 5, 2021

Sex

Female

Sole proprietor

No

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 WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Sound Neurosurgery PLLCGroup PAC ID 1254225899, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
• St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9932/brand/1/csg/1/fhir/r4
• Direct secure messaging: madison.green.1@33199.direct.athenahealth.com

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.

• South Sound Neurosurgery PLLC

  • Neurological Surgery Physician
  • Puyallup, WA
  • NPI 1417992389
  Medicare reassignment Care Compare group NPD
• South Sound Neurosurgery PLLC

  • Durable Medical Equipment & Medical Supplies
  • Puyallup, WA
  • NPI 1013503523
  NPD

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

• Multicare Health System

  • General Acute Care Hospital
  • Puyallup, WA
  • NPI 1841231461
  Care Compare affiliation
• St Francis Community Hospital

  • General Acute Care Hospital
  • Federal Way, WA
  • NPI 1093713091
  Care Compare affiliation
• St Francis Community Hospital

  • Clinical Medical Laboratory
  • Federal Way, WA
  • NPI 1336353069

  Hospital

  Care Compare affiliation
• St Francis Community Hospital

  • General Acute Care Hospital
  • Federal Way, WA
  • NPI 1922305606
  Care Compare affiliation

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1508454661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5141 N 30TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984073305",
            "telephone_number": "360-689-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 3RD ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723742",
            "telephone_number": "253-841-8939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MADISON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61222553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Green
• Dylan Austin Green
• James Green, D.O.
• Jolie Michelle Green
• Kayla L Green, PA-C
• Mary J, Phillips Green, PHD,LMHC,LMFT, LCPC
• Renae Dina Green, CCC-SLP
• Kimberly Greger, RN
• Gregory Chiropractic Inc
• Julian David Gregory II, L.AC.

• Physician Assistant in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.

Verify at the official NPI Registry.