Individual provider Active NPI

Herman Green, P. T.

  • Physical Therapist
  • Washington, DC
National Provider Identifier
1780977090
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT871157 Issued in DC
Practice address
1250 Connecticut Ave NW
Suite 200
Washington, DC 20036-2603
Phone
(202) 261-6598
NPI assigned
May 19, 2011
Last updated
May 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT871157 DC Primary
Physical Therapist 225100000X 23195 MD

Addresses

Primary practice location

1250 Connecticut Ave NW
Suite 200
Washington, DC 20036-2603

Mailing address

10117 Deer Chase
Columbia, MD 21046-1357
Phone (337) 296-4232

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110721000030 DC Practitioner - Physical Therapist in Private Practice 4789852625 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Rehabcare Group East, LLCGroup PAC ID 0042128894, 39 clinicians
Lifestyle Rehab and Wellness LLCGroup PAC ID 6800104886, 3 clinicians

Practice addresses (Care Compare)

1330 Massachusetts Ave NW
Washington, DC 20005-4155
Phone (202) 626-5789

3323 7TH St SE
Washington, DC 20744-4212
Phone (202) 384-9921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23195MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabcare Group East, LLC CurrentSince Sep 13, 2023 Accepting new patients
Lifestyle Rehab and Wellness, LLC CurrentSince Sep 1, 2018 Accepting new patients
Rehabcare Group East LLC Physical Therapist CurrentSince Sep 13, 2023 Accepting new patients

Locations

1330 Massachusetts Ave NW
Washington, DC 20005
Phone (202) 223-0500

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305763200000",
    "number": "1780977090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10117 DEER CHASE",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461357",
            "telephone_number": "337-296-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 CONNECTICUT AVE NW",
            "address_2": "SUITE 200",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200362603",
            "telephone_number": "202-261-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "HERMAN",
        "credential": "P. T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT871157",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23195",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.