NPIMap

Individual provider Active NPI

Sean Michael Greene, PA-C

  • Physician Assistant
  • Corvallis, OR
National Provider Identifier
1831133826
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00664 Issued in OR
Practice address
981 NW Spruce Ave
Corvallis, OR 97330-2111
Phone
(541) 758-0766
Fax
(541) 753-2737
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00664 OR Primary

Addresses

Primary practice location

981 NW Spruce Ave
Corvallis, OR 97330-2111

Mailing address

981 NW Spruce Ave
Corvallis, OR 97330-2111
Phone (541) 758-0766

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address seangreene@direct.practicefusion.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101201000376 OR Practitioner - Physician Assistant 5395931430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley ClinicsGroup PAC ID 4981943776, 13 clinicians

Practice addresses (Care Compare)

3388 Pacific Blvd SW
Albany, OR 97321-7707
Phone (541) 758-0766

981 NW Spruce Ave
Corvallis, OR 97330-2111
Phone (541) 758-0766

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: seangreene@direct.practicefusion.com

Organizations & group practices 2

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 67

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

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1831133826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 NW SPRUCE AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973302111",
            "telephone_number": "541-758-0766",
            "fax_number": "541-753-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981 NW SPRUCE AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973302111",
            "telephone_number": "541-758-0766",
            "fax_number": "541-753-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "seangreene@direct.practicefusion.com",
            "affiliation": "N",
            "address_1": "981 NW Spruce Ave",
            "city": "Corvallis",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973302111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

Verify at the official NPI Registry.