THEODORE GREEN
NPI 1053954776
Nurse Practitioner - Family in Tacoma, WA

Active since October 25, 2019PECOS EnrolledAccepts Medicare Assignment
3716 PACIFIC AVE STE E, TACOMA, WA 98418(253) 474-5141 Get Directions Write a Review

NPPES record last updated: March 18, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 18, 2021, Aug 17, 2020, Mar 9, 2020 and 1 more (4 updates tracked since 2019).

About Theodore Green NPPES

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

THEODORE GREEN (NPI 1053954776) is an individual family provider in Tacoma, Washington, licensed in Washington (AP61015452) and active in the NPI registry since October 2019. He is enrolled in Medicare PECOS, is affiliated with Providence Centralia Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1053954776
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameTHEODORE GREEN
Location Address3716 PACIFIC AVE STE ETacoma, WA 98418-7836
Mailing Address3716 Pacific Ave Ste ETacoma, WA 98418-7836 · (253) 474-5141
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateOctober 25, 2019
Last NPPES UpdateMarch 18, 20214 updates tracked since enumeration
NPPES CertifiedMarch 18, 2021
NPI 1053954776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in WA · AP61015452
3716 PACIFIC AVE STE E, Tacoma, WA 98418

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Theodore Green is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658700489
PECOS Enrollment IDI20200331000330
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.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
275 services166 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
178 services132 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
105 services105 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
55 services28 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
42 services12 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
22 services22 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Providence Centralia Hospital

Acute Care Hospitals · Centralia, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number500019
Location914 S Scheuber RoadCentralia, WA 98531 · Lewis County
Emergency services Birthing friendly

Capital Medical Center

Acute Care Hospitals · Olympia, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500139
Location3900 Capital Mall Dr SWOlympia, WA 98502 · Thurston County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98418 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
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

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

Nurse Practitioner (Psychiatric/Mental Health)
3716 PACIFIC AVE STE E
TACOMA, WA 98418

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 Theodore Green's NPI number?

The NPI number for Theodore Green is 1053954776. It was assigned to this individual provider in the NPPES registry on October 25, 2019.

Where is Theodore Green located?

Theodore Green practices at 3716 Pacific Ave Ste E, Tacoma, WA 98418. The listed phone number is (253) 474-5141.

What is Theodore Green's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Theodore Green enrolled in Medicare?

Yes. Theodore Green is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Theodore Green accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Theodore Green as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Theodore Green affiliated with any hospitals?

According to CMS data, Theodore Green is affiliated with Providence Centralia Hospital and Capital Medical Center.

When was this NPI record last updated?

The NPPES record for Theodore Green was last updated on March 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.