Kerry Scott Green, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

29662 Issued in AZ

Practice address

6112 E Brown Rd
Mesa, AZ 85205-4955

Phone

(480) 924-4422

Fax

(480) 924-8822

NPI assigned

Jun 6, 2006

Last updated

Oct 25, 2011By the provider in NPPES

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Wayne State University School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kerry S Green MD PLCGroup PAC ID 3476538729, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Home Care-Arizona Home health agency, Mesa, AZ, CCN 037015
• Dignity Health at Home Home health agency, Chandler, AZ, CCN 037281
• Grace Home Health Care Home health agency, Mesa, AZ, CCN 037273
• Sunrise Health Services Home health agency, Mesa, AZ, CCN 037226
• Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
• Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122

Merit-based Incentive Payment System (MIPS)

Final score

30.5 of 100Reported as individual

Quality

20

Improvement activities

0

Cost

74.99

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kerry S Green MD PLC

  dba Skyline Medicine

  • Clinic/Center
  • Mesa, AZ
  • NPI 1356523492
  Medicare reassignment Care Compare group NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Apache Healthcare Services Inc.

  dba Sunrise Health Services

  • Home Health Agency
  • Gilbert, AZ
  • NPI 1760449409
  Care Compare affiliation
• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284
  Care Compare affiliation
• Banner Gateway Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1699884858
  Care Compare affiliation
• Banner Home Care-Arizona

  • Home Health Agency
  • Sun City, AZ
  • NPI 1023051927
  Care Compare affiliation
• Dignity Health at Home, LLC

  • Home Health Agency
  • Chandler, AZ
  • NPI 1831678218
  Care Compare affiliation
• Grace Home Health Care, LLC

  • Home Health Agency
  • Mesa, AZ
  • NPI 1881826766
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1801835350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6112 E BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054955",
            "telephone_number": "480-924-4422",
            "fax_number": "480-924-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 E BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054955",
            "telephone_number": "480-924-4422",
            "fax_number": "480-924-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KERRY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "29662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dena A Green, MD
• Donita Green
• Jacob T Green, M.D.
• Jessica P Green
• Judith Green
• Kristen Lee Green, FNP-C
• Rebecca Lyn Green, N.P.
• Victoria Ann Green, NMD
• Wendy Marie Green
• Cassandra Greene, LAC

• Family Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.