Brendan Poe Smith Greenaway, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006973 Issued in MI

Practice address

1500 E Medical Center Drive
9TH Floor University Hospital Recp D
Ann Arbor, MI 48109-5118

Phone

(734) 936-9760

NPI assigned

Jul 30, 2013

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

Opted out of Medicare

Yes, effective Oct 1, 2021 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

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  NPD (past)
• Insight Choices Community Wellness PC

  • Addiction Psychiatry Physician
  • West Hollywood, CA
  • NPI 1700491990
  NPD (past)

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1841632072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE",
            "address_2": "9TH FLOOR UNIVERSITY HOSPITAL RECP D",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095118",
            "telephone_number": "734-936-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENAWAY",
        "first_name": "BRENDAN",
        "middle_name": "POE SMITH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA056178",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Lempert Green, PH.D.
• Lee A Green, MD
• Madeline Green
• Melanie Amanda Green, PHARMD
• Stephanie Green
• Daniel Eli Greenberg, PH.D.
• Harry S Greenberg, MD
• Sidney E Greenberg, MSW
• Lavana Greene-Higgs, MD
• Cynthia Greene, MSW

• Physician Assistant in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.