| Mrs Michelle Renae Green, PA-C | |
|
419 W State St, Mancelona, MI 49659 | |
| (231) 587-9181 | |
| (231) 587-0923 |
| Full Name | Mrs Michelle Renae Green |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 19 Years |
| Location | 419 W State St, Mancelona, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174729818 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 5601005008 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Munson Medical Center | Traverse city, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Munson Medical Center | 3072426287 | 377 |
| Chronic Care Management Llc | 7214150770 | 10 |
| Great Lakes Therapy Housecalls Pc | 7719876580 | 71 |
| Entity Name | Munson Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083761860 PECOS PAC ID: 3072426287 Enrollment ID: O20040108000904 |
| Entity Name | Chronic Care Management LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730506726 PECOS PAC ID: 7214150770 Enrollment ID: O20140602001145 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Michelle Renae Green, PA-C Po Box 769, Mancelona, MI 49659-0769 Ph: (231) 587-9181 | Mrs Michelle Renae Green, PA-C 419 W State St, Mancelona, MI 49659 Ph: (231) 587-9181 |
Michael Max James, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 419 W State St., Mancelona, MI 49659 Phone: 231-587-9181 |
Katherine J Ducharme, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 419 W State St, Mancelona, MI 49659 Phone: 231-587-9181 Fax: 231-587-0923 |
Alexis Kilbourn, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 419 W State St, Mancelona, MI 49659 Phone: 231-587-9181 Fax: 231-587-0923 |