| Michael Alan Green, PA-C | |
|
630 Griffin Ave, Lady Lake, FL 32159-8101 | |
| (872) 231-3162 | |
| Not Available |
| Full Name | Michael Alan Green |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 630 Griffin Ave, Lady Lake, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730257981 | NPI | - | NPPES |
| 1730257981 | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9109683 (Florida) | Primary |
| Entity Name | University of Florida Jacksonville Physicians, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144276452 PECOS PAC ID: 9133025869 Enrollment ID: O20040128000786 |
| Entity Name | Florida Hospital Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174955256 PECOS PAC ID: 2365679057 Enrollment ID: O20131231000600 |
| Entity Name | National Health Rehabilitation LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780080218 PECOS PAC ID: 4284952615 Enrollment ID: O20150821012665 |
| Entity Name | Integrated Rehab Consultants Florida PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245700244 PECOS PAC ID: 4486997426 Enrollment ID: O20190515001526 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Alan Green, PA-C Po Box 22239, New York, NY 10087-0001 Ph: (702) 899-0595 | Michael Alan Green, PA-C 630 Griffin Ave, Lady Lake, FL 32159-8101 Ph: (872) 231-3162 |
Tyler Lyall Hanson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 929 North Us Hwy 441/27, Suite 601, Lady Lake, FL 32159 Phone: 352-633-0473 Fax: 866-208-9972 |
Mr. Aloysius T Bisong Jr., PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 808 Highway 466, Lady Lake, FL 32159 Phone: 352-751-0040 Fax: 352-751-2825 |
Mr. Michael Andrew Humphrey, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 805 E County Road 466, Lady Lake, FL 32159 Phone: 352-674-9218 Fax: 352-259-6069 |
Kelsie Thomas, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 805 County Road 466, Lady Lake, FL 32159 Phone: 352-674-9218 |
Mr. Adrian James Easterling, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 805 E County Road 466, Lady Lake, FL 32159 Phone: 352-674-9218 Fax: 352-259-6069 |
Janice Gallimore, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 805 County Road 466, Lady Lake, FL 32746 Phone: 352-674-9218 |
Caroline Butler, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 805 E. Cr 466, Lady Lake, FL 32159 Phone: 352-674-9218 |