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DR. KIMBERLY J GREEN D.O
NPI 1720174873
General Practice in Alpharetta, GA

Active since October 05, 2006PECOS Enrolled
1090 CAMBRIDGE SQ, SUITE A, ALPHARETTA, GA 30009(770) 754-9880(770) 754-9881 Get Directions Write a Review

NPPES record last updated: July 26, 2013. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Kimberly J Green D.o NPPES

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

DR. KIMBERLY J GREEN D.O (NPI 1720174873) is an individual general practice provider in Alpharetta, Georgia, licensed in Georgia (58478) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and is a graduate of Philadelphia College Of Osteopathic Medicine (2000).

NPPES Registry Identity

NPI1720174873
Entity TypeIndividualFemale
Primary Taxonomy208D00000X
Provider Legal NameDR. KIMBERLY J GREENCredential: D.O
Location Address1090 CAMBRIDGE SQ, SUITE AAlpharetta, GA 30009-1875
Mailing Address1090 Cambridge Sq, Suite AAlpharetta, GA 30009-1875 · (770) 754-9880 · Fax (770) 754-9881
Phone(770) 754-9880
Fax(770) 754-9881
Sole ProprietorNo
Medical School CMSPhiladelphia College Of Osteopathic MedicineGraduated 2000
Enumeration DateOctober 5, 2006
Last NPPES UpdateJuly 26, 2013
✔ NPI 1720174873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Licenses✔ Licensed in GA · 58478✔ Licensed in IN · 2002456A
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
1090 CAMBRIDGE SQ, Alpharetta, GA 30009
Open in Google Maps ↗

Other Identifiers 1

Medicare PIN01BCHWHGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kimberly J Green D.o is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7719987296
PECOS Enrollment IDI20070106000109
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.

Medicare Billing Reassignment

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

Greenline Medical Corporation
1.6 mi
General Practice
804 BOMBAY LN
Roswell, GA 30076
  • Reassigned Medicare billing, Georgia enrollment
NPI 1073810453 (770) 754-9880

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

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
324 services32 patients

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 Kimberly Green's NPI number?

The NPI number for Kimberly Green is 1720174873. It was assigned to this individual provider in the NPPES registry on October 5, 2006.

Where is Kimberly Green located?

Kimberly Green practices at 1090 Cambridge Sq Suite A, Alpharetta, GA 30009. The listed phone number is (770) 754-9880.

What is Kimberly Green's specialty?

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

Is Kimberly Green enrolled in Medicare?

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

Which organization bills Medicare for Kimberly Green's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Green reassigns Medicare benefits to Greenline Medical Corporation (Roswell, GA). 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 Kimberly Green's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberly Green accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Kimberly Green as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kimberly Green was last updated on July 26, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.