Erick Joseph Green Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A130378 Issued in CA

Practice address

2021 Herndon Ave # 101
Clovis, CA 93611-6101

Phone

(559) 797-4315

Fax

(559) 900-7952

NPI assigned

Sep 23, 2011

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

Enrolled in CA

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

General PracticeAlso: Pathology, Sports Medicine

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Premium Urgent Care IncGroup PAC ID 9638306533, 4 clinicians

Premium AllergyGroup PAC ID 5395187223, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.31 of 100Reported as group

Quality

63.06

Improvement activities

40

Cost

72.25

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Premium Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Clovis, CA
  • NPI 1952744070
  Medicare reassignment Care Compare group Authorized official
• Green Sports Medicine Inc

  • Sports Medicine (Family Medicine) Physician
  • Clovis, CA
  • NPI 1396210563
  Medicare reassignment NPD Authorized official
• Premium Health Centers

  • Urgent Care Clinic/Center
  • Los Banos, CA
  • NPI 1477340578
  Medicare reassignment NPD Authorized official
• Premium Allergy

  • Allergy & Immunology Physician
  • Fresno, CA
  • NPI 1578331153
  Medicare reassignment Care Compare group NPD (past)
• Baz Allergy, Asthma & Sinus Center, Inc.

  • Allergy Physician
  • Fresno, CA
  • NPI 1710906995
  Medicare reassignment NPD
• Premium Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Fresno, CA
  • NPI 1619747623
  NPD Authorized official
• Premium Urgent Care Inc

  • Clinical Medical Laboratory
  • Fresno, CA
  • NPI 1265130025
  NPD (past) Authorized official
• Premium Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Clovis, CA
  • NPI 1033502141
  NPD (past) Authorized official
• Premium Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Los Banos, CA
  • NPI 1104296888
  NPD (past) Authorized official
• Premium Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Clovis, CA
  • NPI 1386229896
  NPD (past) Authorized official
• Premium Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Fresno, CA
  • NPI 1821473935
  NPD (past) Authorized official
• Baz Allergy, Asthma & Sinus Center

  • Allergy Physician
  • Clovis, CA
  • NPI 1396328779
  NPD

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1821371022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7471 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202457",
            "telephone_number": "559-436-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 HERNDON AVE # 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116101",
            "telephone_number": "559-797-4315",
            "fax_number": "559-900-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ERICK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-23",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A130378",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A130378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Gables Care Home
• Green Gables Care Home
• Green Lotus Therapy & Consulting, Inc
• Green Sports Medicine Inc
• Courtney Lee Green, LMFT
• Richard Green, PA-C
• Tristian Green
• Greg Paez Jr
• Gregory Stafford Chiropractic, Inc.
• Aneet Kaur Grewal

• Family Medicine Physician in Clovis, CA
• Providers in Clovis, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.
• 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.