Oleander Green, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

1261 Issued in CO

Practice address

4745 Arapahoe Ave Ste 310
Boulder, CO 80303-1082

Phone

(303) 443-2771

NPI assigned

Jun 3, 2024

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Olly Green Other name

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Boulder Valley Ear Nose and Throat Associates PCGroup PAC ID 9234128216, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Boulder Valley Ear Nose & Throat Associates PC

  • Otolaryngology Physician
  • Boulder, CO
  • NPI 1194948026
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1821839028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 PEARL PKWY APT 315",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012495",
            "telephone_number": "920-202-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE STE 310",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803031082",
            "telephone_number": "303-443-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "OLEANDER",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CO",
            "license": "1261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLLY",
            "last_name": "GREEN",
            "credential": "AUD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alan Edward Green, DDS
• Christina Marie Green, MA
• Daniel Green
• Justin D Green, M.D.
• Melissa Green
• Stacy Robin Green, M.D.
• Holly R Greenberg, MSW, LCSW
• Jalen Greene, RBT
• Julie K Greene, LPC
• Ben Greenfield

• Audiologist in Boulder, CO
• Providers in Boulder, CO by specialty
• Audiologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.