Dr Stacy Robin Green, MD is a 
General Practice based in Boulder, Colorado. Dr Stacy Robin Green is licensed to practice in Colorado (license number 50364) and her current practice location is 
825 S Broadway St Ste 100, Boulder, Colorado. She can be reached at her office (for appointments etc.) via phone at 
(303) 717-2521.
NPI number for Dr Stacy Robin Green is 1558686162 and her current mailing address is 825 S Broadway St Ste 100, Boulder, Colorado. She 
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1558686162.
			
			
			
		 
		
		 
Healthcare Provider's Profile
		
			
			
			| Full Name | Dr Stacy Robin Green | 
|---|
| Gender | Female | 
|---|
| Speciality | General Practice | 
|---|
| Location | 825 S Broadway St Ste 100, Boulder, Colorado | 
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. | 
|---|
			
			 
			
						  NPI Data:
			
			- NPI Number: 1558686162
- Provider Enumeration Date: 04/07/2010
- Last Update Date: 10/11/2025
 
		 
		 
Medical Identifiers
		Medical identifiers for Dr Stacy Robin Green such as npi, medicare ID, medicare PIN, medicaid, etc.
		
		| Identifier | Type | State | Issuer | 
|---|
		| 1558686162 | NPI | - | NPPES | 
		
		 
Medical Taxonomies and Licenses
		
		| Taxonomy | Type | License (State) | Status | 
|---|
		| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary | 
| 208D00000X | General Practice | 50364 (Colorado) | Primary | 
		
		
			
			
			
		
		
		 
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 Stacy Robin Green is 
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
		
		
 
Mailing Address and Practice Location
		
		| Mailing Address | Practice Location Address | 
|---|
		| Dr Stacy Robin Green, MD 825 S Broadway St Ste 100,
 Boulder, CO 80305-5932
 Ph: (303) 717-2521
 | Dr Stacy Robin Green, MD 825 S Broadway St Ste 100,
 Boulder, CO 80305-5932
 Ph: (303) 717-2521
 | 
		
		 
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