DR. MICHAEL MATTHEW GREEN D.O. NPI 1063665719

NPI Information

  • NPI: 1063665719
  • Provider Name: DR. MICHAEL MATTHEW GREEN, D.O.
  • Classification: Physical Medicine & Rehabilitation - 2081P0010X
  • Specialization: Pediatric Rehabilitation Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 81 N MARIO CAPECCHI DR
    DEPARTMENT OF PEDIATRICS
    SALT LAKE CITY, UT
    ZIP 84113
  • Phone: (801) 213-7737

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NPI Details

DR. Michael Matthew Green, D.O. is a pediatric rehabilitation medicine physical medicine rehabilitation in Salt Lake City, UT. The provider is a physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care. DR. Michael Matthew Green, D.O. NPI is 1063665719. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

81 N MARIO CAPECCHI DR
DEPARTMENT OF PEDIATRICS
SALT LAKE CITY, UT
ZIP 84113-125
Phone: (801) 213-7737
Fax: (801) 587-7539

The NPI 1063665719 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)

The enumeration date for this NPI number is 10/28/2008 and was last updated on 12/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208100000XPhysical Medicine & RehabilitationBP10031712TEXASNo
22081P0010XPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine2011017820MISSOURINo
32081P0301XPhysical Medicine & RehabilitationBrain Injury Medicine8728465-1204UTAHNo
4390200000XStudent in an Organized Health Care Education/Training ProgramNo
52081P0010XPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine8728465-1204UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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