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DR. JACK GREEN M.D.
NPI 1598010399
Pediatrics in West Hollywood, CA

Active since July 17, 2012PECOS Enrolled
87.67/100
CMS Quality Rating
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048(310) 423-8080 Get Directions Write a Review

NPPES record last updated: September 20, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 20, 2019, Aug 26, 2016, Jun 30, 2016 (3 updates tracked since 2016).

About Dr. Jack Green M.d. NPPES

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

DR. JACK GREEN M.D. (NPI 1598010399) is an individual pediatrics provider in West Hollywood, California, licensed in California (A136598) and active in the NPI registry since July 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1598010399
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. JACK GREENCredential: M.D.
Location Address8700 BEVERLY BLVDWest Hollywood, CA 90048-1804
Mailing Address8700 Beverly Blvd # Nt4255bWest Hollywood, CA 90048-1804 · (310) 423-8080
Phone(310) 423-8080
Sole ProprietorNo
Enumeration DateJuly 17, 2012
Last NPPES UpdateSeptember 20, 20193 updates tracked since enumeration
✔ NPI 1598010399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A136598
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
8700 BEVERLY BLVD, West Hollywood, CA 90048
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jack Green M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90048 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
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
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.

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.

87.67/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.86
Promoting Interoperability99
Improvement Activities40
Cost49.42

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.

DR. BERNICE LOUISE COLEMAN PH.D, ACNP-BC
Nurse Practitioner (Acute Care)
8700 BEVERLY BLVD, NORTH TOWER ROOM 6215
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-6178
DR. INGRID LEAH DOMBROWER M.D.
Psychiatry & Neurology (Psychiatry)
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-2871
ELAINE WITTERT MSW
Social Worker (Clinical)
8700 BEVERLY BLVD, SUITE AC1002
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-3119
DR. KENAN MOHAMMED NADAR D.O.
Pediatrics
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-4451
HAE YOON GRACE CHOUNG MD
Pathology (Anatomic Pathology & Clinical Pathology)
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-6623
CASEY DISTASO MD
Emergency Medicine
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-8780
CHIARA CASAS NP
Nurse Practitioner (Pediatrics)
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-3277
PHILIP CHENG MD
Student in an Organized Health Care Education/Training Program
8700 BEVERLY BLVD
WEST HOLLYWOOD, CA 90048
Los Angeles County (310) 423-1682

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 Jack Green's NPI number?

The NPI number for Jack Green is 1598010399. It was assigned to this individual provider in the NPPES registry on July 17, 2012.

Where is Jack Green located?

Jack Green practices at 8700 Beverly Blvd, West Hollywood, CA 90048. The listed phone number is (310) 423-8080.

What is Jack Green's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jack Green enrolled in Medicare?

Yes. Jack Green is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Green was last updated on September 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.