Madison Green, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10495 Issued in AZ

Practice address

6780 W Thunderbird Rd # A101
Peoria, AZ 85381-5049

Phone

(602) 843-1991

NPI assigned

Jul 5, 2024

Sex

Female

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 AZ

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, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Vernon T Mackey PC

  • Procedural Dermatology Physician
  • Peoria, AZ
  • NPI 1396959417
  Medicare reassignment
• Children'S Medical Group, LTD

  • Pediatrics Physician
  • Glendale, AZ
  • NPI 1003096801
  NPD (past)

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

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1770329070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 W ASPERA BLVD APT 2002",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853087924",
            "telephone_number": "435-669-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6780 W THUNDERBIRD RD # A101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815049",
            "telephone_number": "602-843-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MADISON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Valley Behavioral Homes
• Great Valley Behavioral Homes
• Anna C Green, D.D.S.
• Briana Lyn Green
• Diana Green
• Lisa Mary Greenan, PA-C
• Jeffrey M Greenberg, MD
• Bianca Greene
• Abigail Greenup
• Susan T Gregg, OTR/L

• Physician Assistant in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.