Dr Evan Green, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Plainview, New York. His current practice location is
888 Old Country Rd, Plainview, New York. You can reach out to his office (for appointments etc.) via phone at
(760) 490-7392.
Dr Evan Green is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1023462744.
Physician's Profile
Full Name | Dr Evan Green |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 888 Old Country Rd, Plainview, New York |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1023462744
- Provider Enumeration Date: 04/19/2016
- Last Update Date: 09/22/2022
Medicare PECOS Information:
- PECOS PAC ID: 1951645183
- Enrollment ID: I20221027002499
Medical Identifiers
Medical identifiers for Dr Evan Green such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1023462744 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207XX0801X | Orthopaedic Surgery - Orthopaedic Trauma | 02006914A (Indiana) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Evan Green allows following entities to bill medicare on his behalf.
Entity Name | Deaconess Hospital Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1427097443 PECOS PAC ID: 9032021431 Enrollment ID: O20040115000129 |
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Entity Name | Deaconess Specialty Physicians, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1306344817 PECOS PAC ID: 0244595205 Enrollment ID: O20180702001637 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Evan Green is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Evan Green, DO 888 Old Country Rd, Plainview, NY 11803-4914 Ph: (760) 490-7392 | Dr Evan Green, DO 888 Old Country Rd, Plainview, NY 11803-4914 Ph: (760) 490-7392 |
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