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ROXANNE NICOLE GREENE
NPI 1679099402
Physical Therapist - Pediatrics in Mesa, AZ

Active since August 14, 2017
2642 E FAIRFIELD ST, MESA, AZ 85213(480) 848-4281(480) 393-7040 Get Directions Write a Review

NPPES record last updated: May 31, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 20, 2018, Aug 14, 2017 (2 updates tracked since 2017).

About Roxanne Nicole Greene NPPES

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

ROXANNE NICOLE GREENE (NPI 1679099402) is an individual pediatrics provider in Mesa, Arizona, licensed in Arizona (13242) and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1679099402
Entity TypeIndividualFemale
Primary Taxonomy2251P0200X
Provider Legal NameROXANNE NICOLE GREENE
Location Address2642 E FAIRFIELD STMesa, AZ 85213
Mailing AddressPo Box 267Queen Creek, AZ 85142-1805
Phone(480) 848-4281
Fax(480) 393-7040
Sole ProprietorNo
Enumeration DateAugust 14, 2017
Last NPPES UpdateMay 31, 20222 updates tracked since enumeration
NPPES CertifiedMay 31, 2022
✔ NPI 1679099402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Therapist · PediatricsRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251P0200X
License✔ Licensed in AZ · 13242
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given.
Also ListedPhysical TherapistTaxonomy 225100000X · License 13242 (AZ)
2642 E FAIRFIELD ST, Mesa, AZ 85213
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Roxanne Nicole Greene is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Roxanne Greene reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
621 mi
Internal Medicine
7373 WEST LANE
Stockton, CA 95210
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1548343510 (209) 476-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

ALEXANDRA GANTNER M.A., CCC-SLP
Speech-Language Pathologist
2642 E FAIRFIELD ST
MESA, AZ 85213
Maricopa County (402) 321-0406
MRS. SHANNON ELIZABETH MCKIVITZ DPT
Physical Therapist
2642 E FAIRFIELD ST
MESA, AZ 85213
Maricopa County (480) 848-4281

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 Roxanne Greene's NPI number?

The NPI number for Roxanne Greene is 1679099402. It was assigned to this individual provider in the NPPES registry on August 14, 2017.

Where is Roxanne Greene located?

Roxanne Greene practices at 2642 E Fairfield St, Mesa, AZ 85213. The listed phone number is (480) 848-4281.

What is Roxanne Greene's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Pediatrics, with taxonomy code 2251P0200X.

Is Roxanne Greene enrolled in Medicare?

Yes. Roxanne Greene is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Roxanne Greene's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Roxanne Greene reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, 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 Roxanne Greene'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 Roxanne Greene was last updated on May 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.