DR. BEN NMI GREEN (PHD) – Clinical Psychologist, NPI 1104882927

DR. BEN NMI GREEN (PHD) is a healthcare provider. based in Madison, Wisconsin. specializing in Clinical Psychologist. They hold the professional credentials PHD. They hold a License No. 31440-020 (WI). The NPI Number for DR. BEN NMI GREEN (PHD) is 1104882927

Main info

Male
37 Years Of Experience
Accepts Medicare Assignment
Name
DR. BEN NMI GREEN (PHD)
NPI
1104882927
Phone
(608) 833-9290
Address
7617 MINERAL POINT RD
Enumeration Date
21 April 2006
Last Update Date
19 January 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6088339290
Graduation Year
1989 (37 years ago)
PAC ID
4486649258
Group Practice PAC ID
6507857463
Professional Enrollment ID
I20040420000316
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for DR. BEN NMI GREEN (PHD)

  • 7617, Mineral Point Road, Madison, Dane County, Wisconsin, 53705, United States

    STE 300

    MADISON, WI 537171623

    Phone: (608) 833-9290

    Fax: (608) 833-9691

    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: 2004-04-20

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
I20040420000316IClinical PsychologistWITBD

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 53717)

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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: 6507857463View full group profile
NameSpecialtyState
-WI
Mental Health CounselorWI
-WI
Clinical PsychologistWI
Marriage And Family TherapistWI
Clinical Social WorkerWI
Clinical Social WorkerWI
Clinical PsychologistWI
Mental Health CounselorWI
Clinical Social WorkerWI

Reviews

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Frequently asked questions

Can I cross-check DR. BEN NMI GREEN (PHD) using NPI 1104882927?
NPI 1104882927 belongs to DR. BEN NMI GREEN (PHD); compare other details if you need extra assurance.
Is DR. BEN NMI GREEN (PHD) shown as active in public data?
Registry records indicate DR. BEN NMI GREEN (PHD) maintains an active NPI.
What kind of doctor is DR. BEN NMI GREEN (PHD)?
DR. BEN NMI GREEN (PHD) is associated with Clinical Psychologist in the directory — Clinical services aligned with this taxonomy classification.
Is DR. BEN NMI GREEN (PHD) located near Madison?
DR. BEN NMI GREEN (PHD) currently maps to Madison, Wisconsin in this extract.
Can I trust this NPI listing for DR. BEN NMI GREEN (PHD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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