ROGER ELLIOTT GREEN MD
NPI 1215917968
Dermatology in San Clemente, CA
About Roger Elliott Green Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ROGER ELLIOTT GREEN MD (NPI 1215917968) is an individual dermatology provider in San Clemente, California, licensed in California (C36384) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Louisville School Of Medicine (1973).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
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
Roger Elliott Green Md 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 Roger Green reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Clemente, CA 92673
- Reassigned Medicare billing, California enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 15
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 92673 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.
Reported Quality Measures
Other Providers at the Same Location NPPES 19
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN CLEMENTE, CA 92673
SAN CLEMENTE, CA 92673
SAN CLEMENTE, CA 92673
SAN CLEMENTE, CA 92673
SAN CLEMENTE, CA 92673
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 Roger Green's NPI number?
The NPI number for Roger Green is 1215917968. It was assigned to this individual provider in the NPPES registry on January 19, 2006.
Where is Roger Green located?
Roger Green practices at 657 Camino De Los Mares Suite 242, San Clemente, CA 92673. The listed phone number is (949) 496-6066.
What is Roger Green's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Roger Green enrolled in Medicare?
Yes. Roger 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 Roger Green's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Roger Green reassigns Medicare benefits to Green Dermatologic Medical Group A Medical Corporation (San Clemente, CA). 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 Roger 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 Roger Green was last updated on November 18, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Roger Elliott Green, MD · NPI 1215917968
Dermatology physician in San Clemente, California. Individual provider, active in the CMS NPPES registry since January 19, 2006.
## Identity
- **NPI:** 1215917968 (Entity type: Individual)
- **Enumerated:** January 19, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **State license:** C36384 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 657 CAMINO DE LOS MARES, SUITE 242, San Clemente, CA 92673
- **Phone:** (949) 496-6066 · **Fax:** (949) 496-6497
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Green Dermatologic Medical Group A Medical Corporation (NPI 1154533685, San Clemente, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Louisville School Of Medicine, class of 1973
## Record status
- **NPPES last updated:** November 18, 2009
- **Other identifiers:** Medicare ID-Type Unspecified W13458A (CA); Medicare UPIN A36245
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Source: [NPI Profile](https://npiprofile.com/npi/1215917968) · Data from the CMS NPPES public registry.