Matthew Green, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-05441 Issued in NC

Practice address

2311 Lewisville Clemmons Rd
Clemmons, NC 27012-8905

Phone

(336) 713-0400

NPI assigned

Oct 27, 2014

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 NC

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgreen2755335@carolinashealthcaresystem.direct-ci.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.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment Care Compare group NPD
• Wake Forest Health Network LLC

  dba Atrium Health Wake Forest Baptist Pediatrics - Greensboro

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1477785756
  Medicare reassignment
• Wake Forest Health Network LLC

  dba Atrium Health Wake Forest Baptist Clinical Pharmacy & Diabetes/Nutriti

  • Internal Medicine Physician
  • High Point, NC
  • NPI 1770825390
  NPD
• Wake Forest Health Network, LLC

  dba Atrium Health Levine Children's Pediatrics Northwest

  • Pediatrics Physician
  • Greensboro, NC
  • NPI 1053175299
  NPD

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1588069066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1188 YADKINVILLE RD",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282037",
            "telephone_number": "336-713-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 LEWISVILLE CLEMMONS RD",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128905",
            "telephone_number": "336-713-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-27",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-05441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Brice Goins
• Catherine Walter Goodyear, P.A.-C
• Andrew Gosnell
• Katherine Adams Gossett, MD
• Andrew C Green, D.C.
• Paul Green, PA-C
• Flavia R. Griffin, CCC
• Haley Trivette Grimm, FNP
• Rut Guanipa
• James G Guerrini, MD

• Medical Physician Assistant in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.