Ronaldo Antonio Green, PA-C, ATC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9119963 Issued in FL

Practice address

60 Columbia St
Orlando, FL 32806-1115

Phone

(321) 843-2584

NPI assigned

May 16, 2019

Last updated

Apr 29, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577
  Medicare reassignment Care Compare group NPD
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1619533544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 HABERSHAM DR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "321-843-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "RONALDO",
        "middle_name": "ANTONIO",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-16",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4575",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9119963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Green
• Mackenzy Green, DPT
• Pamela Green, PH.D.
• Patricia Ann Green, PHD
• Patricia D Green, LICENSED HOMEMAKER C
• Sarah Anne Green, PA-C
• Shaebriana Green
• Tanicia Green
• Tracey Ann Green
• Tysie Green, M.ED.

• Surgical Physician Assistant in Orlando, FL
• Providers in Orlando, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.