JEFFERY GREEN (M.D.) – Family Medicine Physician, NPI 1215911904

JEFFERY GREEN (M.D.) is a healthcare provider. based in Fairmont, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 42651 (MN). The NPI Number for JEFFERY GREEN (M.D.) is 1215911904

Main info

Male
29 Years Of Experience
Accepts Medicare Assignment
Name
JEFFERY GREEN (M.D.)
NPI
1215911904
Phone
(507) 238-8555
Address
800 MEDICAL CENTER DR
Enumeration Date
6 December 2005
Last Update Date
17 September 2020

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO
Secondary Phone
5072388555
Graduation Year
1997 (29 years ago)
PAC ID
5991760647
Group Practice PAC ID
4981694981
Professional Enrollment ID
I20041123000026
Address ID
MN560314575FA800XXDRXX400
Telehealth
Yes

Contacts

Secure Messaging
jgreen87666@ehrdirect.mayoclinicmsg.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

3,075 FAMILY PRACTICE in MN

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Provider Addresses for JEFFERY GREEN (M.D.)

  • The Drive, Norwood, Fairmont, Marion County, West Virginia, 26554, United States

    FAIRMONT, MN 560314575

    Phone: (507) 238-8555

    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)

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: 2004-11-23

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
I20041123000026IFamily PracticeMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes804411$0
99215Established patient office or other outpatient visit, 40-54 minutes4840$0
View full utilization report →

Insurance plans in this area (ZIP 56031)

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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: 4981694981View full group profile
NameSpecialtyState
-MN
-MN
-MN
Diagnostic RadiologyMN
Advanced Heart Failure And Transplant Cardiology, Cardiovascular Disease (Cardiology)MN
O P T O M E T R YMN
-MO
-MN
Cardiovascular Disease (Cardiology)MN
Cardiovascular Disease (Cardiology)WI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What unique ID ties claims to JEFFERY GREEN (M.D.)?
NPI 1215911904 is assigned to JEFFERY GREEN (M.D.) under the national enumeration system.
Does this profile mean JEFFERY GREEN (M.D.) is currently active?
Yes — JEFFERY GREEN (M.D.) appears active in the national provider directory.
What field does JEFFERY GREEN (M.D.) work in?
You can think of JEFFERY GREEN (M.D.) as practicing within Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does JEFFERY GREEN (M.D.) practice in Minnesota?
You will see Fairmont, Minnesota on file for JEFFERY GREEN (M.D.) alongside any extra practice locations.
How can I contact JEFFERY GREEN (M.D.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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