Individual provider Active NPI

Lonny Stenzler Green, M.D.

  • Urology Physician
  • Richmond, VA
National Provider Identifier
1962476283
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
0101049895 Issued in VA
Practice address
12129 Graham Meadows Dr
Richmond, VA 23233-6661
Phone
(804) 288-4084
Fax
(804) 282-2601
NPI assigned
Feb 14, 2006
Last updated
May 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 0101049895 VA Primary

Addresses

Primary practice location

12129 Graham Meadows Dr
Richmond, VA 23233-6661

Mailing address

7130 Glen Forest Dr
Suite 101
Richmond, VA 23226-3754
Phone (804) 288-4084

Other identifiers 1

IdentifierTypeStateIssuer
1962476283MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20060127000770 VA Practitioner - Urology 6002820156 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101049895VAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Apr 18, 2018 Accepting new patients
Virginia Womens Center Inc CurrentSince Jan 1, 2011 Accepting new patients
Privia Medical Group, LLC CurrentSince Apr 18, 2018 Accepting new patients
Summit Health Care Inc Past Accepting new patients
Summit Health Care, Inc. Past Accepting new patients

Locations

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

930 South Ave
Ste 2
Colonial Hgts, VA 23834
Phone (804) 520-8272

8644 Sudley Rd
#220
Manassas, VA 20110

12129 Graham Meadows Dr
Richmond, VA 23233

5875 Bremo Rd
Ste 400
Richmond, VA 23226
Phone (804) 287-3550

7130 Glen Forest Dr
Ste 101
Richmond, VA 23226

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1962476283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7130 GLEN FOREST DR",
            "address_2": "SUITE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263754",
            "telephone_number": "804-288-4084",
            "fax_number": "804-282-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12129 GRAHAM MEADOWS DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232336661",
            "telephone_number": "804-288-4084",
            "fax_number": "804-282-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LONNY",
        "middle_name": "STENZLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VA",
            "license": "0101049895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962476283",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.