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MR. CHARLES WESLEY GREEN III FNP-BC, FNP-C
NPI 1609604859
Nurse Practitioner - Family in Sherman Oaks, CA

Active since July 22, 2024PECOS Enrolled
4445 COLBATH AVE APT 107, SHERMAN OAKS, CA 91423(859) 620-4762 Get Directions Write a Review

NPPES record last updated: July 22, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Charles Wesley Green Iii Fnp-bc, Fnp-c NPPES

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

MR. CHARLES WESLEY GREEN III FNP-BC, FNP-C (NPI 1609604859) is an individual family provider in Sherman Oaks, California, licensed in California (784730) and active in the NPI registry since July 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1609604859
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMR. CHARLES WESLEY GREEN IIICredential: FNP-BC, FNP-C
Location Address4445 COLBATH AVE APT 107Sherman Oaks, CA 91423-3523
Mailing Address4445 Colbath Ave Apt 107Sherman Oaks, CA 91423-3523 · (859) 620-4762
Phone(859) 620-4762
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJuly 22, 2024
NPPES CertifiedJuly 21, 2024
✔ NPI 1609604859 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · 784730
4445 COLBATH AVE APT 107, Sherman Oaks, CA 91423
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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)

Mr. Charles Wesley Green Iii Fnp-bc, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1850899956
PECOS Enrollment IDI20250808000441
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 91423 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.

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 Charles Green's NPI number?

The NPI number for Charles Green is 1609604859. It was assigned to this individual provider in the NPPES registry on July 22, 2024.

Where is Charles Green located?

Charles Green practices at 4445 Colbath Ave Apt 107, Sherman Oaks, CA 91423. The listed phone number is (859) 620-4762.

What is Charles Green's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Charles Green enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Charles Green was last updated on July 22, 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.