Brenton Michael Green, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PAC0858 Issued in ND

Practice address

900 E Broadway Ave
Bismarck, ND 58501-4520

Phone

(701) 530-7000

NPI assigned

Oct 28, 2020

Last updated

Oct 28, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in ND

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Alexius Medical CenterGroup PAC ID 8426960865, 239 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Alexius Health Hospital, Bismarck, ND, CCN 350002
• CHI St Alexius Health Dickinson Hospital, Dickinson, ND, CCN 351336

Merit-based Incentive Payment System (MIPS)

Final score

83.48 of 100Reported as group

Quality

73.03

Promoting interoperability

100

Improvement activities

40

Cost

71.91

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. Alexius Medical Center

  dba CHI St. Alexius Health Clinics

  • Specialist
  • Bismarck, ND
  • NPI 1205868429
  Medicare reassignment Care Compare group NPD
• St Alexius Medical Center

  dba CHI St. Alexius Health

  • Home Infusion Therapy Pharmacy
  • Bismarck, ND
  • NPI 1063663607
  NPD
• Community Memorial Hospital

  • Internal Medicine Physician
  • Hamilton, NY
  • NPI 1932100393
  NPD (past)

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

• St. Alexius Medical Center

  dba CHI St. Alexius Health

  • General Acute Care Hospital
  • Bismarck, ND
  • NPI 1306832654
  Care Compare affiliation
• St. Joseph's Hospital and Health Center

  dba CHI St Alexius Health Dickinson

  • Critical Access Hospital
  • Dickinson, ND
  • NPI 1992947956
  Care Compare affiliation

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1538769633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 BUTTERFIELD DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038061",
            "telephone_number": "218-230-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014520",
            "telephone_number": "701-530-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRENTON",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "PAC0858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thandiwe C Gray, M.D.
• Todd A Gray, MD
• Great Plains Restorative Services, LLC
• Great Plains Security Systems Inc.
• Alain Mathew Green, MSN, APRN, FNP-C
• Mika Green, MD
• Alexis Jan Greenstein
• Victoria Lee Gregg
• Donald H Grenz, MD
• Melodee J Grenz, CRNA

• Physician Assistant in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.