Theodore Green, in Tacoma, WA - Medicare Nurse Practitioner

Theodore Green, is a medicare enrolled "Nurse Practitioner - Family" in Tacoma, Washington. His current practice location is 3716 Pacific Ave Ste E, Tacoma, Washington. You can reach out to his office (for appointments etc.) via phone at (253) 474-5141.

Theodore Green is licensed to practice in Washington (license number AP61015452) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1053954776.

Contact Information

	Theodore Green,
	3716 Pacific Ave Ste E, Tacoma, WA 98418-7836
	(253) 474-5141
	Not Available

Map and Direction

Provider's Profile

Full Name	Theodore Green
Gender	Male
Speciality	Nurse Practitioner - Family
Location	3716 Pacific Ave Ste E, Tacoma, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1053954776
Provider Enumeration Date: 10/25/2019
Last Update Date: 03/18/2021

Medicare PECOS Information:

PECOS PAC ID: 1658700489
Enrollment ID: I20200331000330

Medical Identifiers

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

Identifier	Type	State	Issuer
1053954776	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	AP61015452 (Washington)	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. Theodore Green allows following entities to bill medicare on his behalf.

Entity Name	Tumwater Family Practice Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881638559 PECOS PAC ID: 4587553268 Enrollment ID: O20040311000816

Entity Name	Capital Medical Center Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629214283 PECOS PAC ID: 3678639879 Enrollment ID: O20090312000311

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. Theodore 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
Theodore Green, 3716 Pacific Ave Ste E, Tacoma, WA 98418-7836 Ph: (253) 474-5141	Theodore Green, 3716 Pacific Ave Ste E, Tacoma, WA 98418-7836 Ph: (253) 474-5141

Reviews and Comments

Nurse Practitioner Nurses in Tacoma, WA

Salome Odja Dockendorf, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1201 Pacific Ave Ste 19501201, Tacoma, WA 98402 Phone: 812-870-6728
Barbara L Kapuscinski, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9040 Jackson Ave, Tacoma, WA 98431 Phone: 253-968-2751
Ms. Christine J. Larsen, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3580 Pacific Ave, Tacoma, WA 98418 Phone: 253-798-4500 Fax: 253-798-4493
Rick Hahn, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 315 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-403-1000
Mrs. Kimberley Anne Burns, APRN,BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1617 S J St, Tacoma, WA 98405 Phone: 253-274-7504
Randi Marie Berg, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9040 Reid St, Tacoma, WA 98431 Phone: 253-968-2315
Marlene I Bridgforth, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1901 S Cedar St, #301 Cardiac Study Center Inc Ps, Tacoma, WA 98405 Phone: 253-572-7320 Fax: 253-627-3191

Theodore Green, - Medicare Nurse Practitioner in Tacoma, WA