Robert Green, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.0059515 Issued in CO

Practice address

1311 N Mildred Rd
Cortez, CO 81321-2299

Phone

(970) 564-2146

NPI assigned

Nov 24, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, TX, CO3 enrollments

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 3

Specialty

Family Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Plata Family Medicine Assoc PCGroup PAC ID 5496727240, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.green@5176137285636.direct.elationemr.com

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.

• La Plata Family Medicine Assoc PC

  • Family Medicine Physician
  • Durango, CO
  • NPI 1609868116
  Medicare reassignment Care Compare group NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Shiprock, NM
  • NPI 1780639971

  TX

  Medicare reassignment NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000

  Family Medicine

  Medicare reassignment NPD
• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Teecnospos, AZ
  • NPI 1477615789
  NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• San Carlos Apache Healthcare Corporation

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD
• Institute of Cardiovascular Excellence PLLC

  • Cardiovascular Disease Physician
  • Ocala, FL
  • NPI 1295975803

  Family Medicine

  NPD (past)
• Northwest Florida Primary Care LLC

  • Hospitalist Physician
  • Niceville, FL
  • NPI 1740429679
  NPD (past)
• VMG Urgent Care PA

  • Urgent Care Clinic/Center
  • The Villages, FL
  • NPI 1922327824
  NPD (past)

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1902134380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 8TH AVE W STE 101",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342214737",
            "telephone_number": "941-776-4008",
            "fax_number": "941-845-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N MILDRED RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813212299",
            "telephone_number": "970-564-2146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 N Tuttle Ave",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342375229",
            "country_code": "US",
            "telephone_number": "941-366-0800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8877 SE 165th Mulberry Ln",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "321625887",
            "country_code": "US",
            "telephone_number": "352-674-1750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-24",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS6664",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0059515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenna Nichole Goddard, COTA
• Dina Gonzales
• Erin Gordanier
• Michael Daniel Grajeda, DPT
• Alyssa Grams, LCSW
• Gerald Wayne Griebel, M.D.
• Marilyn Griebel, CNP
• Emilee A Griese Blair
• Justin Grisham, D.O.
• Tyson Craig Grose, DMD

• Family Medicine Physician in Cortez, CO
• Providers in Cortez, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.