Active NPI
Alan Rustin Greene, M.D.
- Pediatrics Physician
- Palo Alto, CA
National Provider Identifier
1699822304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G063446
- Practice address
- 730 Welch Rd
Primary Care Clinic, First Floor
Palo Alto, CA 94304-1503 - Phone
- (925) 964-1793
- Fax
- (925) 964-1794
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G063446 | CA | Primary |
Addresses
Primary practice location
730 Welch Rd
Primary Care Clinic, First Floor
Palo Alto, CA 94304-1503
Mailing address
9000 Crow Canyon Rd
Ste S-220
Danville, CA 94506-1189
Phone (925) 964-9464
Other names 1
- Prof. Alan Rustin Greene
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G063446 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LPCH Medical Group Div of Lucile | Pediatrics | Current | Accepting new patients |
Locations
9000 Crow Canyon Rd
Ste S220
Danville, CA 94506
730 Welch Rd
Fl First
Palo Alto, CA 94304
Phone (925) 964-1793
725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979
Interoperability endpoints
- alan.greene@302934149496836.direct.elationemr.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699822304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 CROW CANYON RD",
"address_2": "STE S-220",
"city": "DANVILLE",
"state": "CA",
"postal_code": "945061189",
"telephone_number": "925-964-9464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 WELCH RD",
"address_2": "PRIMARY CARE CLINIC, FIRST FLOOR",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041503",
"telephone_number": "925-964-1793",
"fax_number": "925-964-1794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "ALAN",
"middle_name": "RUSTIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G063446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALAN",
"last_name": "GREENE",
"middle_name": "RUSTIN",
"prefix": "PROF.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.