Raymond Karl Greene, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

845 Issued in ID

Practice address

850 W Ironwood Dr
Suite 104
Coeur D Alene, ID 83814-4903

Phone

(208) 765-2020

Fax

(208) 765-1460

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ferris State College - College of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: raymond.greene@uprisedirect.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.

• Coeur Dalene Vision Source

  • Optometrist
  • Coeur D Alene, ID
  • NPI 1598881351

  ID

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1689669798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 W IRONWOOD DR",
            "address_2": "SUITE 104",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144903",
            "telephone_number": "208-765-2020",
            "fax_number": "208-765-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W IRONWOOD DR",
            "address_2": "SUITE 104",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144903",
            "telephone_number": "208-765-2020",
            "fax_number": "208-765-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "RAYMOND",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002691400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spencer D Greendyke, MD
• Alissa Greene
• Brandon Greene, D.O.
• Lindsey Marie Greene, NP
• Magdelena Greene, MD
• Jessica Aubry Greensides, NP
• Angela Greer, OTR
• Meghan Gregg, NP
• Gregory R. Keese, M.D., P.C.
• Gregory V Parsons PA

• All providers in Coeur D Alene, ID
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.