Anthony Trevor Green, D. D. S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0473299 Issued in NY

Practice address

17836 Wexford Ter
Suite 2E
Jamaica, NY 11432-3024

Phone

(718) 739-1300

Fax

(718) 739-0966

NPI assigned

Nov 8, 2005

Sex

Male

Sole proprietor

No

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 NY, MA2 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 2

Specialty

Oral SurgeryAlso: Maxillofacial Surgery

Education

Howard University College of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oral Surgery Associates Southcoast, Inc.Group PAC ID 9436208477, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: agreen839305@nychhc.direct-ci.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.

• Oral Surgery Associates Southcoast, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • New Bedford, MA
  • NPI 1043255383
  Medicare reassignment Care Compare group
• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407
  Medicare reassignment NPD
• Anthony T.R. Green D.D.S.P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Jamaica, NY
  • NPI 1235392283
  NPD (past) Authorized official

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1972584969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17836 WEXFORD TER",
            "address_2": "SUITE 2E",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323024",
            "telephone_number": "718-739-1300",
            "fax_number": "718-739-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17836 WEXFORD TER",
            "address_2": "SUITE 2E",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323024",
            "telephone_number": "718-739-1300",
            "fax_number": "718-739-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ANTHONY",
        "middle_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "D. D. S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "0473299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02166558",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyla Telia Greaves
• Green Leaf Acupuncture PC
• Donnamarie Green-Lilly
• Alexus Alexandria Green
• Andrea N Green, ANP
• Bishop Green
• Ceceile McIntosh Green, MS, PHD CANDIDATE
• Fredrique Green
• Latoya Green
• Mildred Green

• Oral and Maxillofacial Surgery (Dentist) in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.