Michael Douglas Green, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13335 Issued in CA

Practice address

1300 W 7TH St
San Pedro, CA 90732-3505

Phone

(310) 514-5350

Fax

(310) 514-5421

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reddy Urgent Care IncGroup PAC ID 4284884982, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Reddy Urgent Care,Inc

  • Urgent Care Clinic/Center
  • Long Beach, CA
  • NPI 1093062473
  Medicare reassignment Care Compare group
• Cep America - California

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843
  Medicare reassignment
• Stephen R Shea, M.D., Inc

  • Emergency Medicine Physician
  • San Pedro, CA
  • NPI 1942239033
  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Long Beach, CA
  • NPI 1144849530
  NPD

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1922030576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661360",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910661360",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W 7TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323505",
            "telephone_number": "310-514-5350",
            "fax_number": "310-514-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MICHAEL",
        "middle_name": "DOUGLAS",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA13335",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Elizabeth Grant, PHARMD
• Valerie Grant, MD
• Maricela H Gray
• Great Harbor Family & Sports Medicine, Inc
• Green Health Acupuncture
• Lawrence Bruce Greenberg, M.D.
• Katelyn Greenspan, MA, LMFT
• Gregory Owens Licensed Marriage and Therapy Inc
• Gregory R. Keese, MD Inc, a Profession of Medicine
• Judith Grey, LCSW

• Physician Assistant in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.