CHARLES R GREEN (PA-C) – Physician Assistant, NPI 1962574285
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
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Provider Addresses for CHARLES R GREEN (PA-C)
Grand River Avenue, Petoskey-Otsego, Detroit, Wayne County, Michigan, 48240, United States
PETOSKEY, MI 497708913
Phone: (231) 348-9200
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 78 Open Payments records for all available years, with a total value of $1,275.
Total Amount is formed as General ($1,275) + Research ($0) + Ownership ($0) = $1,275.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Novartis Pharmaceuticals Corporation ($529).
Total Amount
$1,275
General + Research + Ownership
Payments
78
Total payment records
General Amount
$1,275
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novartis Pharmaceuticals Corporation | $529 |
| E.R. Squibb & Sons, L.L.C. | $440 |
| Janssen Biotech, Inc. | $103 |
| Dermavant Sciences, Inc. | $101 |
| Amgen Inc. | $51 |
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: 2004-07-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040709001281 | I | Physician Assistant | MI | 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 |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 1,888 | 211 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 536 | 366 | $0 |
| 17004 | Destruction of precancer skin growth, 15 or more growths | 484 | 343 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 283 | 232 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 213 | 54 | $0 |
Insurance plans in this area (ZIP 49770)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | MI | 17003 | Destruction of 2-14 skin growths | 5889 | 695 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| Internal Medicine, Pediatric Medicine | MI | |
| - | MI |
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