Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles Green

Individual provider Physician Assistant · NPI 1730907437

Charles Green is a Physician Assistant in Indianapolis, Indiana. Graduated from Michigan State University College of Osteopathic Medicine in 2025, 1 year ago. Licensed in Indiana.

Years since qualifying
1
Trained at
Michigan State University College of Osteopathic Medicine
Licensed in
IN
In the registry since
2024
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Practice location Address checks out

931 E 86th St Ste 104
Indianapolis, IN 46240-1852
Phone: (317) 257-1484
Fax: (317) 257-1488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10005186A (IN)

Record details

NPI number1730907437
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 1, 2024
Last updated in NPPESMarch 11, 2026
Certification dateMarch 11, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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