Bert Green, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD00016483 Issued in WA

Practice address

16259 Sylvester Rd SW
Ste 404
Burien, WA 98166-3049

Phone

(206) 248-0800

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Burien Digestive Health Center LLC

  • Gastroenterology Physician
  • Burien, WA
  • NPI 1720386493
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1508855925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16259 SYLVESTER RD SW",
            "address_2": "SUITE 404",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663049",
            "telephone_number": "206-248-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16259 SYLVESTER RD SW",
            "address_2": "STE 404",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663049",
            "telephone_number": "206-248-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00016483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060036294",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1890003",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellee Louise Gore
• Patrick Douglas Gorrell, DC
• Daniel W Gottlieb, MD PS
• Rebecca A Grady, MA.
• Stacie Grace Grage, LPN
• David C Green, M.D.
• Daniel E Greenan, DPM
• Chelsa Greene, FNP-BC
• Mark Greenfield, MD
• Scott Victor Greenspahn, M.D.

• Cardiovascular Disease Physician in Burien, WA
• Providers in Burien, WA by specialty
• Cardiovascular Disease Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.