Kevin Robert Green, MD

Primary specialty

AcupuncturistTaxonomy code 171100000X

Practice address

1259 W 20TH Ave
Oshkosh, WI 54902-6650

Phone

(920) 651-3600

Fax

(920) 265-1360

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 24, 2017 through Aug 24, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Fox Valley Wellness Center/Midwest Hyperbarics

  • Specialist
  • Fond Du Lac, WI
  • NPI 1821376419
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1801901897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 W 20TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026650",
            "telephone_number": "920-651-3600",
            "fax_number": "920-651-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 W 20TH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549026650",
            "telephone_number": "920-651-3600",
            "fax_number": "920-265-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KEVIN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "33989",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grandpa Ray'S Home Care Partners LLC
• Catherine Irene Gransell, LMT
• Jessica D Grant
• Shayna Grassl
• Annette Gray
• Julie Marie Grieves, PH.D.
• Lauren Grill
• Kelly Griseta
• Gretta C. Grube, APNP
• Sarah Elizabeth Grunke, PA-C

• Acupuncturist in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Acupuncturist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.