Individual provider Active NPI

Steven J Green, MD

  • Otolaryngology Physician
  • Willimantic, CT
National Provider Identifier
1942236989
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
027282 Issued in CT
Practice address
36 Watson St
Willimantic, CT 06226-2122
Phone
(860) 456-0287
Fax
(860) 456-3532
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0602X 027282 CT
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0905X 027282 CT
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X 027282 CT Primary

Addresses

Primary practice location

36 Watson St
Willimantic, CT 06226-2122

Mailing address

36 Watson St
Willimantic, CT 06226-2122
Phone (860) 456-0287

Other identifiers 1

IdentifierTypeStateIssuer
001272822MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20100526000000 CT Practitioner - Otolaryngology 7810026143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Temple University School of Medicine, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

36 Watson St
Willimantic, CT 06226-2122

9825 S Jordan Gtwy
Sandy, UT 84070-2561

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
027282CTMDOtolaryngic Allergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose & Throat Associates of Worcester, Inc. Single Specialty CurrentSince Jan 2, 2024 Accepting new patients
Charlton Family Practice Single Specialty Past Accepting new patients

Locations

145 Pomfret St
Putnam, CT 06260
Phone (860) 928-5248

145 Pomfret St
Lowr
Putnam, CT 06260

246 Southbridge Rd
Lowr
Charlton, MA 01507
Phone (508) 980-7074

246 Southbridge Rd
Charlton, MA 01507
Phone (508) 248-4801

Interoperability endpoints

  • Direct secure messaging: sgreen@ecent.gwaydirect.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 5

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

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1942236989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 WATSON ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262122",
            "telephone_number": "860-456-0287",
            "fax_number": "860-456-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 WATSON ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262122",
            "telephone_number": "860-456-0287",
            "fax_number": "860-456-3532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "CT",
            "license": "027282",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CT",
            "license": "027282",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CT",
            "license": "027282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001272822",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.