| Jared A Green, PA-C | |
|
1870 N Main St Ste 201, Cedar City, UT 84721-7742 | |
| (435) 383-9009 | |
| (435) 383-9010 |
| Full Name | Jared A Green |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 21 Years |
| Location | 1870 N Main St Ste 201, Cedar City, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134198419 | NPI | - | NPPES |
| 067405 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 8441754-1206 (Utah) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Zion's Way Home Health | St. george, UT | Home health agency |
| Intermountain Health Cedar City Hospital | Cedar city, UT | Hospital |
| Intermountain Health St George Regional Hospital | St george, UT | Hospital |
| Intermountain Health Sevier Valley Hospital | Richfield, UT | Hospital |
| Grover C Dils Medical Center | Caliente, NV | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Revere Health Pc | 7517868508 | 407 |
| Revere Health Pc | 7517868508 | 407 |
| Entity Name | Revere Health PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20120111000778 |
| Mailing Address | Practice Location Address |
|---|---|
| Jared A Green, PA-C 1055 North 500 West Attn: Credentialing, Provo, UT 84604-3305 Ph: (801) 354-8225 | Jared A Green, PA-C 1870 N Main St Ste 201, Cedar City, UT 84721-7742 Ph: (435) 383-9009 |
Sarah Heaton, PA-C, MPAS Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1303 N Main St, Cedar City, UT 84721 Phone: 435-868-5500 |
Ms. Stacie Carbine, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1303 N Main St, Cedar City, UT 84721 Phone: 435-868-5000 |
Steve C. Newman, P.A. Physician Assistant Medicare: Medicare Enrolled Practice Location: 166 W 1325 N, Suite 150, Cedar City, UT 84720 Phone: 435-586-6962 Fax: 435-867-1663 |
Kassidee Grace Brunson, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 551 W 2150 N, Cedar City, UT 84721 Phone: 970-629-5221 |
Matthew David Rynearson, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 110 W 1325 N Ste 200, Cedar City, UT 84721 Phone: 435-586-7676 Fax: 435-586-2290 |
Mccall Johnson Miller, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 827 Cedarwood Cir, Cedar City, UT 84720 Phone: 435-559-2118 |
Tenille Marshane Anderson, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 110 W 1325 N Ste 200, Cedar City, UT 84721 Phone: 435-586-7676 |