Jacob T Green, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

41389 Issued in AZ

Practice address

6750 E Baywood Ave
301
Mesa, AZ 85206-1749

Phone

(480) 835-6100

Fax

(480) 505-5295

NPI assigned

Dec 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

University of Arizona College of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-City Cardiology Consultants PCGroup PAC ID 2062303076, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Banner Heart Hospital Hospital, Mesa, AZ, CCN 030105
• Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088
• Honorhealth Four Peaks Medical Center Hospital, Mesa, AZ, CCN 030121
• Banner Ironwood Medical Center Hospital, Queen Creek, AZ, CCN 030130
• Banner Desert Medical Center Hospital, Mesa, AZ, CCN 030065

Merit-based Incentive Payment System (MIPS)

Final score

85.24 of 100Reported as group

Quality

74.76

Promoting interoperability

100

Improvement activities

40

Cost

76.03

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: jacob.green.p1@direct.tcc.nextgenshare.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.

• Tri-City Cardiology Consultants, PC

  • Cardiovascular Disease Physician
  • Mesa, AZ
  • NPI 1144288416
  Medicare reassignment Care Compare group NPD
• Banner Cancer Center Specialists LLC

  • Oncology Clinic/Center
  • Phoenix, AZ
  • NPI 1518253152
  Medicare reassignment NPD
• Banner Cancer Center Specialists LLC

  • Oncology Clinic/Center
  • Payson, AZ
  • NPI 1588158448
  NPD
• Tri-City Cardiology Consultants, PC

  • Cardiac Rehabilitation Registered Nurse
  • Mesa, AZ
  • NPI 1689417636
  NPD

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

• Banner Baywood Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1194758284
  Care Compare affiliation
• Banner Desert Medical Center

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1720011810
  Care Compare affiliation
• Banner Heart Hospital

  • Special Hospital
  • Mesa, AZ
  • NPI 1215961248
  Care Compare affiliation
• Banner Ironwood Medical Center

  • General Acute Care Hospital
  • Queen Creek, AZ
  • NPI 1124341672
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1427875061
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Florence, AZ
  • NPI 1497572036
  Care Compare affiliation
• Honorhealth

  • General Acute Care Hospital
  • Mesa, AZ
  • NPI 1861219404
  Care Compare affiliation

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1932384773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6402 E SUPERSTITION SPRINGS BLVD STE 224",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064394",
            "telephone_number": "480-835-6100",
            "fax_number": "480-505-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 E BAYWOOD AVE",
            "address_2": "301",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061749",
            "telephone_number": "480-835-6100",
            "fax_number": "480-505-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JACOB",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-28",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "054383",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AZ",
            "license": "41389",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AZ",
            "license": "41389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424562",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louis G Greco, MD
• Thomas G Greco, D.M.D.
• Green 32 PLLC
• Dena A Green, MD
• Donita Green
• Jessica P Green
• Judith Green
• Kerry Scott Green, M.D.
• Kristen Lee Green, FNP-C
• Rebecca Lyn Green, N.P.

• Interventional Cardiology Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Interventional Cardiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.