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

Daniel Robert Green

Individual provider Physician Assistant · NPI 1700288966

Daniel Robert Green is a Physician Assistant in Fayetteville, New York. Qualified in 2014, 12 years ago. Practices with Guthrie Medical Group PC, a 797-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
12
In the registry since
2014
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Practice location Address checks out

212 Highbridge St Ste A
Fayetteville, NY 13066-1981
Phone: (315) 637-9116
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1700288966
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 18, 2014
Last updated in NPPESSeptember 18, 2014
Mailing address212 Highbridge St, Suite A, Fayetteville, NY 13066-1981

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Guthrie Medical Group Pc — 797 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Fayetteville