TANNER JAMES GREEN
NPI 1093473647
Physician Assistant in Simi Valley, CA
About Tanner James Green NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TANNER JAMES GREEN (NPI 1093473647) is an individual physician assistant in Simi Valley, California, licensed in California (60441) and active in the NPI registry since December 2021. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
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
Tanner James 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.
Areas of Expertise CMS Part B claims 3
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 93065 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SIMI VALLEY, CA 93065
SIMI VALLEY, CA 93065
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 Tanner Green's NPI number?
The NPI number for Tanner Green is 1093473647. It was assigned to this individual provider in the NPPES registry on December 1, 2021.
Where is Tanner Green located?
Tanner Green practices at 2975 Sycamore Dr, Simi Valley, CA 93065. The listed phone number is (805) 955-6107.
What is Tanner Green's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Tanner Green enrolled in Medicare?
Yes. Tanner 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.
When was this NPI record last updated?
The NPPES record for Tanner Green was last updated on March 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.
# Tanner James Green · NPI 1093473647
Physician Assistant physician in Simi Valley, California. Individual provider, active in the CMS NPPES registry since December 1, 2021.
## Identity
- **NPI:** 1093473647 (Entity type: Individual)
- **Enumerated:** December 1, 2021
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** 60441 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 2975 SYCAMORE DR, Simi Valley, CA 93065-1201
- **Phone:** (805) 955-6107
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** March 27, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1093473647) · Data from the CMS NPPES public registry.