KATHLEEN GREEN (CRNA) – Certified Registered Nurse Anesthetist, NPI 1386792224

KATHLEEN GREEN (CRNA) is a healthcare provider. based in Riverside, California. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. NA3206 (CA). The NPI Number for KATHLEEN GREEN (CRNA) is 1386792224

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
KATHLEEN GREEN (CRNA)
NPI
1386792224
Phone
(909) 353-2000
Address
10800 MAGNOLIA AVE
Enumeration Date
8 January 2007
Last Update Date
2 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9513532000
Graduation Year
2005 (21 years ago)
PAC ID
6608810205
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20050614001506
Address ID
CA925053043RI10800AVEX300

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

2,456 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in CA

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Provider Addresses for KATHLEEN GREEN (CRNA)

  • Kaiser Permanente Riverside Medical Center, 10800, Magnolia Avenue, Riverside, Riverside County, California, 92505, United States

    RIVERSIDE, CA 925053043

    Phone: (909) 353-2000

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $829.

Total Amount is formed as General ($829) + Research ($0) + Ownership ($0) = $829.

Last reported payment date: 2023-04-07 • Largest payer in this snapshot: Edwards Lifesciences Corporation ($829).

Total Amount

$829

General + Research + Ownership

Payments

2

Total payment records

General Amount

$829

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-07

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-06-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050614001506ICertified Registered Nurse Anesthetist (Crna)CATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92505)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

Does KATHLEEN GREEN (CRNA) have a public NPI I can cite?
Public records show KATHLEEN GREEN (CRNA) under NPI 1386792224.
Does the public listing show KATHLEEN GREEN (CRNA) as active?
KATHLEEN GREEN (CRNA)'s NPI record reflects an active status in NPPES.
Which specialty label fits KATHLEEN GREEN (CRNA)?
NPPES ties KATHLEEN GREEN (CRNA) to Certified Registered Nurse Anesthetist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to KATHLEEN GREEN (CRNA)?
KATHLEEN GREEN (CRNA) is associated with Riverside, California in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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