ALICE GREEN RD
NPI 1063059632
Dietitian, Registered in Saint Paul, MN
About Alice Green Rd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ALICE GREEN RD (NPI 1063059632) is an individual dietitian, registered in Saint Paul, Minnesota and active in the NPI registry since December 2019. She maintains a secondary practice location in Mount Vernon and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Alice Green Rd 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.
Medicare Billing Reassignment
Medicare enrollment records show Alice Green reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
St Paul, MN 55102
- Reassigned Medicare billing, Minnesota enrollment
- 2,609 clinicians in this Medicare group
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 55102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 14
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAINT PAUL, MN 55102
SAINT PAUL, MN 55102
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 Alice Green's NPI number?
The NPI number for Alice Green is 1063059632. It was assigned to this individual provider in the NPPES registry on December 3, 2019.
Where is Alice Green located?
Alice Green practices at 280 Smith Ave N Ste 700, Saint Paul, MN 55102. The listed phone number is (651) 241-6600.
What is Alice Green's specialty?
The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.
Is Alice Green enrolled in Medicare?
Yes. Alice 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.
Which organization bills Medicare for Alice Green's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Alice Green reassigns Medicare benefits to Allina Health System (St Paul, MN). The 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 Alice 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 Alice Green was last updated on August 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Alice Green, RD · NPI 1063059632
Dietitian, Registered provider in Saint Paul, Minnesota. Individual provider, active in the CMS NPPES registry since December 3, 2019.
## Identity
- **NPI:** 1063059632 (Entity type: Individual)
- **Enumerated:** December 3, 2019
- **Primary specialty:** Dietitian, Registered · taxonomy 133V00000X
- **Sole proprietor:** No
## Practice location
- **Address:** 280 SMITH AVE N STE 700, Saint Paul, MN 55102-2972
- **Phone:** (651) 241-6600
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Allina Health System (NPI 1003205410, St Paul, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** August 13, 2024
- **Other identifiers:** Medicaid 164007727 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1063059632) · Data from the CMS NPPES public registry.