Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1619935335 Individual Practitioner Male Practitioner

Carl Lee Green , PA

Physician Assistant • Kingman, KS

Professional Overview & Biography Verified Profile Summary

Carl Green, PA is a registered healthcare professional specializing in Physician Assistant in Kingman, KS. Practice services are available at 750 W D AVE under active NPI credentials.

Frequently performed procedures and clinical services include injection, fosaprepitant, 1 mg, injection, epoetin alfa, (for non-esrd use), 1000 units, injection, dexamethasone sodium phosphate, 1 mg. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

750 W D Ave

Kingman, KS 670681266

Telephone 6205323147
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Kingman, KS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.0 Yrs
State Avg: 14.0 Yrs
Regional Practice Density
7 Specialists

Practicing in Kingman, KS (1349 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
39.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2018)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
J1453 Injection, fosaprepitant, 1 mg
4,200 12 $3.00 $2.04
J0885 Injection, epoetin alfa, (for non-esrd use), 1000 units
2,060 11 $32.00 $12.69
J1100 Injection, dexamethasone sodium phosphate, 1 mg
1,144 27 $2.00 $0.12
J2405 Injection, ondansetron hydrochloride, per 1 mg
768 14 $1.00 $0.08
J2469 Injection, palonosetron hcl, 25 mcg
460 13 $78.00 $20.50
96375 Injection of additional new drug or substance into vein
204 24 $54.00 $14.17
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention
192 31 $45.00 $16.28
96366 Infusion into a vein for therapy, prevention, or diagnosis, each additional hour
134 12 $78.00 $17.40
96413 Infusion of chemotherapy into a vein up to 1 hour
126 26 $265.00 $110.32
96367 Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less
96 27 $85.00 $24.73
96415 Administration of chemotherapy into vein, each additional hour
80 14 $140.00 $24.47
96365 Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less
49 17 $150.00 $56.73
J1200 Injection, diphenhydramine hcl, up to 50 mg
44 13 $2.00 $0.58
96417 Administration of additional new drug or substance into vein, 1 hour or less
43 12 $167.00 $53.14
J2505 Injection, pegfilgrastim, 6 mg
18 11 $6900.00 $4525.07

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License KS 1500576

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Blue Cross/blue Shield
042639 (KS)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Kathleen Prilliman , ARNP

Nurse Practitioner

NPI 1063467728

Advanced Registered Nurse Practitioner

Danielle Cox , RD

Dietitian, Registered

NPI 1356947204

Registered Dietitian

Jeremy Lickteig

Family Medicine

NPI 1366016610
NPI 1396744223

Doctor of Medicine (M.D.)

Dr. Krishnakumar Kotecha , MD

Radiology - Diagnostic Radiology

NPI 1477650703

Doctor of Medicine (M.D.)

Paul Halderson

Physician Assistant

NPI 1649671710

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 750 W D AVE, KINGMAN, KS 670681266 (Tel: 6205323147)

📍
Updated Business Mailing Address July 09, 2007

Registered at 1015 N FIREFLY CIR, WICHITA, KS 672359437 (Tel: 3167215284)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as CARL GREEN, P.A.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Physician Assistant (License #1500576 in KS)

🟢
Initial NPI Registration & Enumeration May 02, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619935335
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 02, 2006
Last Update: July 13, 2026
Sole Proprietor: No

Mailing Address

1015 N Firefly Cir

Wichita, KS 672359437

Phone: 3167215284

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.