Justin L Green (NPI# 1114966462, PAC ID# 4880601137) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1114966462 |
| PAC ID by PECOS | 4880601137 |
| Professional Enrollment ID | I20190124000444 |
| Full Name | Justin L Green |
| Organization Legal Name | LOS ALAMOS PHYSICIAN PRACTICES LLC |
| Address |
3917 W Rd 139 Los Alamos Surgical Associates Los Alamos NM 87544-5307 |
| Phone Number | 5056613030 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF KANSAS SCHOOL OF MEDICINE |
| Graduation Year | 1994 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 4587661541 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 320033 | LOS ALAMOS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 3917 W Rd, 139 Los Alamos Surgical Associates, Los Alamos, NM 87544-5307 | 5056613030 | LOS ALAMOS PHYSICIAN PRACTICES LLC |
| Organization Legal Name | LOS ALAMOS PHYSICIAN PRACTICES LLC |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Fei Gu | Hematology/oncology | Los Alamos Physician Practices LLC | 3917 W Rd, 225 Northern New Mexico Cancer Care, Los Alamos, NM 87544-5311 |
| Timothy M Lopez | Medical Oncology | Los Alamos Physician Practices LLC | 3917 W Rd, 225 Northern New Mexico Cancer Care, Los Alamos, NM 87544-5311 |
| Salim Amrani | General Surgery | Los Alamos Physician Practices LLC | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Karen L Lorusso | Medical Oncology | Los Alamos Physician Practices LLC | 3917 W Rd, 139 Los Alamos Surgical Associates, Los Alamos, NM 87544-5307 |
| Kurt Charles Lange | Gastroenterology | Los Alamos Physician Practices LLC | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Daniel Marancenbaum | Obstetrics/gynecology | Los Alamos Physician Practices LLC | 3917 W Rd, Los Alamos, NM 87544-5307 |
| Nelson Roberto Pou | Obstetrics/gynecology | Los Alamos Physician Practices LLC | 3917 W Rd, Los Alamos, NM 87544-5307 |
| Glendon E Cook | Family Medicine | Los Alamos Physician Practices LLC | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Gary S Kipp | Obstetrics/gynecology | Los Alamos Physician Practices LLC | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Eric T Ifune | General Surgery | Los Alamos Physician Practices LLC | 3917 W Rd, Los Alamos, NM 87544-5307 |
| Street Address |
3917 W RD 139 LOS ALAMOS SURGICAL ASSOCIATES |
| City | LOS ALAMOS |
| State | NM |
| Zip | 87544-5307 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lori S Whitley | Dermatology | Los Alamos Medical Care Clinic Ltd | 3917 W Rd, Suite 150, Los Alamos, NM 87544-5303 |
| Fei Gu | Hematology/oncology | Los Alamos Physician Practices LLC | 3917 W Rd, 225 Northern New Mexico Cancer Care, Los Alamos, NM 87544-5311 |
| Ann C. Linnebur | Cardiovascular Disease (cardiology) | Medical Associates of Northern New Mexico | 3917 W Rd, Suite A, Los Alamos, NM 87544-2292 |
| Christopher A Gutierrez | Emergency Medicine | Los Alamos Emergency Medical Associates Inc | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Molly J Vosburg | Internal Medicine | Medical Associates of Northern New Mexico | 3917 W Rd, Suite A, Los Alamos, NM 87544-2292 |
| Indra Prasad R Peram | Family Medicine | Apogee Medical Group New Mexico Inc | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Jeanne M Beyerle | Physician Assistant | Los Alamos Medical Care Clinic Ltd | 3917 W Rd, Suite 150, Los Alamos, NM 87544-5303 |
| Michelle Certik | Physician Assistant | Medical Associates of Northern New Mexico | 3917 W Rd, Suite A, Los Alamos, NM 87544-2292 |
| Eric M Ketcham | Emergency Medicine | Los Alamos Emergency Medical Associates Inc | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Madhavi Garimella | Endocrinology | Medical Associates of Northern New Mexico | 3917 W Rd, Suite A, Los Alamos, NM 87544-2292 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Wesley C Pruett | Diagnostic Radiology | Virtual Radiologic Professionals LLC | 5600 Quemazon, Los Alamos, NM 87544-1765 |
| Jeffrey M Sauer | Podiatry | 3917 W Rd, Suite 135, Los Alamos, NM 87544-1776 | |
| Nicolle L Gonzales | Certified Nurse Midwife | Bridge Care for Women LLC | 3500 Trinity Dr, Los Alamos, NM 87544-2221 |
| Tom S. Steward | Clinical Social Worker | 3250 Trinity Dr, Suite B3, Los Alamos, NM 87544-2226 | |
| Michael J Marvinny | Hospitalist | Apogee Medical Group New Mexico Inc | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Josiah H Child | Emergency Medicine | Los Alamos Emergency Medical Associates Inc | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Miguel Dozier | Emergency Medicine | Los Alamos Emergency Medical Associates Inc | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Steven E Evans | Anesthesiology | Pueblo Anesthesia and Pain Services | 3917 W Rd, Pueblo Anesthesia and Pain Management, Los Alamos, NM 87544-2275 |
| Salim Amrani | General Surgery | Los Alamos Physician Practices LLC | 3917 W Rd, Los Alamos, NM 87544-2275 |
| Bethany Wooten | Certified Registered Nurse Anesthetist (crna) | Pueblo Anesthesia and Pain Services | 3917 W Rd, Pueblo Anesthesia and Pain Management, Los Alamos, NM 87544-2275 |
| Find all physicians in zip 87544 | |||
| City | LOS ALAMOS |
| Zip Code | 87544 |
| Specialty | GENERAL SURGERY |
| City + Specialty | LOS ALAMOS + GENERAL SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.