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DR. STACY ROBIN GREEN M.D.
NPI 1558686162
General Practice in Boulder, CO

Active since April 07, 2010
825 S BROADWAY ST STE 100, BOULDER, CO 80305(303) 717-2521 Get Directions Write a Review

NPPES record last updated: October 22, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 11, 2025, Jan 27, 2021, Apr 1, 2020 and 1 more (4 updates tracked since 2018).

About Dr. Stacy Robin Green M.d. NPPES

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

DR. STACY ROBIN GREEN M.D. (NPI 1558686162) is an individual general practice provider in Boulder, Colorado, licensed in Colorado (DR.0050364) and active in the NPI registry since April 2010.

NPPES Registry Identity

NPI1558686162
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameDR. STACY ROBIN GREENCredential: M.D.
Location Address825 S BROADWAY ST STE 100Boulder, CO 80305-5932
Mailing Address825 S Broadway St Ste 100Boulder, CO 80305-5932 · (303) 717-2521
Phone(303) 717-2521
Sole ProprietorYes
Enumeration DateApril 7, 2010
Last NPPES UpdateOctober 22, 20254 updates tracked since enumeration
NPPES CertifiedOctober 22, 2025
✔ NPI 1558686162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CO · DR.0050364
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedPsychiatry & Neurology · Psychosomatic MedicineTaxonomy 2084P0015X · License DR.0050364 (CO)
825 S BROADWAY ST STE 100, Boulder, CO 80305
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Other Providers at the Same Location NPPES 2

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

EMERGENCE PSYCHEDELIC THERAPY, LLC
Clinic/Center
825 S BROADWAY ST STE 100
BOULDER, CO 80305
Boulder County (303) 578-8845
STACY GREEN ENTERPRISES, LLC
Clinic/Center (Health Service)
825 S BROADWAY ST STE 100
BOULDER, CO 80305
Boulder County (303) 717-2521

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 Stacy Green's NPI number?

The NPI number for Stacy Green is 1558686162. It was assigned to this individual provider in the NPPES registry on April 7, 2010.

Where is Stacy Green located?

Stacy Green practices at 825 S Broadway St Ste 100, Boulder, CO 80305. The listed phone number is (303) 717-2521.

What is Stacy Green's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Stacy Green was last updated on October 22, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.