Provider Demographics
NPI:1982865531
Name:GREEN-SIMMS, AMY E (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:GREEN-SIMMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:GREENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1155 21ST ST NW STE M400
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3336
Mailing Address - Country:US
Mailing Address - Phone:202-296-4900
Mailing Address - Fax:202-293-3409
Practice Address - Street 1:1155 21ST ST NW STE M400
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3336
Practice Address - Country:US
Practice Address - Phone:202-296-4900
Practice Address - Fax:202-293-3409
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD039830207W00000X
MDD0072996207W00000X
MN51120207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
IAENROLLEDMedicaid
WI35357700Medicaid
MNP00878271OtherRAILROAD MEDICARE
MNENROLLEDMedicaid