Dr Sydjea M Green, PHD - Medicare Psychologist in Southlake, TX

Dr Sydjea M Green, PHD is a medicare enrolled "Psychologist" provider in Southlake, Texas. Her current practice location is 1230 N Kimball Ave Ste 130, Southlake, Texas. You can reach out to her office (for appointments etc.) via phone at (833) 667-7924.

Dr Sydjea M Green is licensed to practice in Texas (license number 39576) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1750004248.

Contact Information

Dr Sydjea M Green, PHD
1230 N Kimball Ave Ste 130,
Southlake, TX 76092-4707
(833) 667-7924
(817) 755-0945

Map and Direction




Healthcare Provider's Profile

Full NameDr Sydjea M Green
GenderFemale
SpecialityPsychologist
Location1230 N Kimball Ave Ste 130, Southlake, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1750004248
  • Provider Enumeration Date: 09/21/2022
  • Last Update Date: 09/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 2961848197
  • Enrollment ID: I20240311002597

Medical Identifiers

Medical identifiers for Dr Sydjea M Green such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1750004248NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 39576 (Texas)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. Dr Sydjea M Green allows following entities to bill medicare on her behalf.
Entity NameShiny Triangle Lcsw Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164175105
PECOS PAC ID: 1254727480
Enrollment ID: O20220414002466

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 Sydjea M 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 AddressPractice Location Address
Dr Sydjea M Green, PHD
126 Floyd St,
Brentwood, NY 11717-2646

Ph: (631) 336-0695
Dr Sydjea M Green, PHD
1230 N Kimball Ave Ste 130,
Southlake, TX 76092-4707

Ph: (833) 667-7924

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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