Ottavia Kimberly Green, MD in Park Ridge, IL

Ottavia Kimberly Green, MD is a medicare enrolled "Anesthesiology" physician in Park Ridge, Illinois. Her current practice location is 1775 Dempster St, Park Ridge, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 723-2210.

Ottavia Kimberly Green is licensed to practice in Illinois (license number 036-170213) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1336701861.

Contact Information

	Ottavia Kimberly Green, MD
	1775 Dempster St, Park Ridge, IL 60068-1143
	(847) 723-2210
	Not Available

Map and Direction

Physician's Profile

Full Name	Ottavia Kimberly Green
Gender	Female
Speciality	Anesthesiology
Location	1775 Dempster St, Park Ridge, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1336701861
Provider Enumeration Date: 07/04/2019
Last Update Date: 10/29/2024

Medicare PECOS Information:

PECOS PAC ID: 6507196193
Enrollment ID: I20240402002112

Medical Identifiers

Medical identifiers for Ottavia Kimberly Green such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336701861	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207L00000X	Anesthesiology	2019022382 (Missouri)	Secondary
207L00000X	Anesthesiology	V0407 (Texas)	Secondary
207L00000X	Anesthesiology	036-170213 (Illinois)	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. Ottavia Kimberly Green allows following entities to bill medicare on her behalf.

Entity Name	Cd Practice Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295787919 PECOS PAC ID: 2567359839 Enrollment ID: O20040302000290

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. Ottavia Kimberly 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
Ottavia Kimberly Green, MD 29373 Network Pl, Chicago, IL 60673-1293 Ph: () -	Ottavia Kimberly Green, MD 1775 Dempster St, Park Ridge, IL 60068-1143 Ph: (847) 723-2210

Reviews and Comments

Anesthesiology Doctors in Park Ridge, IL

Nancy Gonzalez, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: Lutheran General Hospital, 1775 Dempster Ave, Park Ridge, IL 60068 Phone: 847-723-1773
David Tian Chin, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1775 Dempster St Ste Aip, Park Ridge, IL 60068 Phone: 800-655-2656 Fax: 412-822-7411
Linda Castaneda, DO Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1775 W Dempster St, Park Ridge, IL 60068 Phone: 847-723-2210
Caroline Ter Rahe, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1775 W Dempster St, Park Ridge, IL 60068 Phone: 847-723-2210
Ethan Jordan Parnass, Anesthesiology Medicare: Medicare Enrolled Practice Location: 1775 Dempster St, Park Ridge, IL 60068 Phone: 847-723-2210 Fax: 847-723-3532
Dr. Osman Nawazish Salaria, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1775 Dempster St, Park Ridge, IL 60068 Phone: 847-723-2210 Fax: 847-723-3532
Dr. Jeffrey John Podnar, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1775 W. Dempster, Park Ridge, IL 60068 Phone: 847-723-2210

Ottavia Kimberly Green, MD - Medicare Anesthesiology in Park Ridge, IL