MARY ETOSHA GREEN (MD) – Anatomic Pathology & Clinical Pathology Physician, NPI 1154827350
Anatomic Pathology & Clinical Pathology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
323 PATHOLOGY in CT
Provider Addresses for MARY ETOSHA GREEN (MD)
71 HAYNES ST
MANCHESTER, CT 060404131
Phone: (860) 646-1222
Fax: (866) 623-8110
Type: Location
One Medical Center Blvd Winston Salem
Winston Salem, NC 271570001
Phone: (337) 716-9954
Fax: (337) 716-7595
Type: Location
64 Robbins St
Waterbury, CT 067082613
Phone: (860) 646-1222
Fax: (866) 623-8110
Type: Location
31 Union St
Vernon, CT 060663126
Phone: (860) 646-1222
Fax: (866) 623-8110
Type: Location
Medical Center Boulevard, Ardmore, Winston-Salem, Forsyth County, North Carolina, 27157, United States
WINSTON SALEM, NC 271570001
Phone: (336) 716-9954
Fax: (336) 716-7595
Type: Mailing
ONE MEDICAL CENTER BLVD WINSTON SALEM
WINSTON SALEM, NC 271570001
Phone: (337) 716-9954
Fax: (337) 716-7595
Type: Location
PO BOX 844770
BOSTON, MA 022844770
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2023-08-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230801001748 | I | Pathology | MA | TBD |
| I20230801002688 | I | Pathology | CT | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 320 | 125 | $0 |
| 88313 | Special stained specimen slides to examine tissue including interpretation and report | 132 | 57 | $0 |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 60 | 53 | $0 |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 20 | 11 | $0 |
| 88112 | Cell examination of specimen, selective cellular enhancement technique | 14 | 14 | $0 |
Insurance plans in this area (ZIP 06040)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | MA | |
| Dermatology, Pathology | TX | |
| P A T H O L O G Y | CT | |
| P A T H O L O G Y | CT | |
| - | NY | |
| P A T H O L O G Y | CT | |
| P A T H O L O G Y | MA | |
| P A T H O L O G Y | NC | |
| P A T H O L O G Y | MA | |
| P A T H O L O G Y | MA |
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