Individual provider Active NPI

John A Green Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Seattle, WA
National Provider Identifier
1811240252
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60361340 Issued in WA
Practice address
325 9TH Ave
Seattle, WA 98104-2420
Phone
(206) 744-3059
NPI assigned
Oct 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP60361340 WA Primary

Addresses

Primary practice location

325 9TH Ave
Seattle, WA 98104-2420

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 543-6420

Other identifiers 1

IdentifierTypeStateIssuer
1811240252MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR, TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140326000130 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789836958 Reassigns benefits to 1 organization
I20190208001855 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789836958 Reassigns benefits to 1 organization
I20210524000769 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789836958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411

Hospital & facility affiliations

  • Southeast Alaska Regional Health Consortium Hospital, Sitka, AK, CCN 021314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP60361340WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Nurse Anesthetist, Certified Registered CurrentSince Dec 3, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Nurse Anesthetist, Certified Registered CurrentSince Dec 3, 2018 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Dec 3, 2018 Accepting new patients
South East Alaska Regional Health Consortium CurrentSince May 18, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Nurse Anesthetist, Certified Registered Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince May 18, 2021 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients

Locations

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

10180 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2880

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 7

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.

Hospital & facility affiliations 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1811240252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042420",
            "telephone_number": "206-744-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JOHN",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-23",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60361340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811240252",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.