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STACEY D GREEN NP
NPI 1053374397
Nurse Practitioner in Los Angeles, CA

Active since April 08, 2006PECOS Enrolled
200 UCLA MEDICAL PLZ STE 120, LOS ANGELES, CA 90095(310) 206-9260(310) 794-1649 Get Directions Write a Review

NPPES record last updated: January 2, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Stacey D Green Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACEY D GREEN NP (NPI 1053374397) is an individual nurse practitioner in Los Angeles, California, licensed in California (602389) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053374397
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSTACEY D GREENCredential: NP
Location Address200 UCLA MEDICAL PLZ STE 120Los Angeles, CA 90095-1835
Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631
Phone(310) 206-9260
Fax(310) 794-1649
Sole ProprietorNo
Enumeration DateApril 8, 2006
Last NPPES UpdateJanuary 2, 2020
✔ NPI 1053374397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CA · 602389
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
200 UCLA MEDICAL PLZ STE 120, Los Angeles, CA 90095
Open in Google Maps ↗

Other Identifiers 1

MedicaidRN602389CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Stacey D Green Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Stacey Green reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

The Regents Of The University Of California
Same address
Internal Medicine
200 MEDICAL PLAZA, SUITE 365,530,420,250,120,214
Los Angeles, CA 90095
  • Reassigned Medicare billing, California enrollment
  • 1,766 clinicians in this Medicare group
NPI 1235107566 (310) 794-1276
Robert P Kahn-Rose, Inc.
20 mi
Specialist
30423 CANWOOD ST STE 123
Agoura Hills, CA 91301
  • Reassigned Medicare billing, California enrollment
  • 13 clinicians in this Medicare group
NPI 1407936784 (818) 385-1219

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90095 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE ALIMI N.P.
Nurse Practitioner (Adult Health)
200 UCLA MEDICAL PLZ STE 120
LOS ANGELES, CA 90095
Los Angeles County (310) 206-6909
MAX JORDAN NGUEMENI TIAKO
Internal Medicine
200 UCLA MEDICAL PLZ STE 120
LOS ANGELES, CA 90095
Los Angeles County (310) 206-6909
VICTORIA PINTADO NP
Nurse Practitioner (Acute Care)
200 UCLA MEDICAL PLZ STE 120
LOS ANGELES, CA 90095
Los Angeles County (310) 206-6909
ERI HIROFUJI NURSE PRACTITIONER
Nurse Practitioner
200 UCLA MEDICAL PLZ STE 120
LOS ANGELES, CA 90095
Los Angeles County (310) 206-6909
CHIANTALL ANNE OLALIA PARAS FNP-C
Nurse Practitioner
200 UCLA MEDICAL PLZ STE 120
LOS ANGELES, CA 90095
Los Angeles County (310) 206-6909
MISS RACHEL LYNN SCHULZ FNP
Nurse Practitioner (Family)
200 UCLA MEDICAL PLZ STE 120
LOS ANGELES, CA 90095
Los Angeles County (310) 206-6909
ERICA SUZANNE MARTINEZ NP
Nurse Practitioner
200 UCLA MEDICAL PLZ STE 120
LOS ANGELES, CA 90095
Los Angeles County (310) 206-6909
DEBBIE JOY ZAMORA AGACNP-BC
Nurse Practitioner
200 UCLA MEDICAL PLZ STE 120
LOS ANGELES, CA 90095
Los Angeles County (310) 206-6909

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacey Green's NPI number?

The NPI number for Stacey Green is 1053374397. It was assigned to this individual provider in the NPPES registry on April 8, 2006.

Where is Stacey Green located?

Stacey Green practices at 200 Ucla Medical Plz Ste 120, Los Angeles, CA 90095. The listed phone number is (310) 206-9260.

What is Stacey Green's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Stacey Green enrolled in Medicare?

Yes. Stacey Green is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Stacey Green's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stacey Green reassigns Medicare benefits to 2 organizations: The Regents Of The University Of California (Los Angeles, CA) and Robert P Kahn-Rose, Inc. (Agoura Hills, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stacey Green's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Stacey Green was last updated on January 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.