Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kristian Ashley Green, PA-C

Individual provider Physician Assistant · NPI 1073859401

Kristian Ashley Green, PA-C is a Physician Assistant in Elgin, Illinois. Qualified in 2012, 14 years ago. Practices with Orthomidwest, PLLC, a 537-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
14
Licensed in
IL
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1550 N Randall Rd
Elgin, IL 60123-7876
Phone: (815) 398-9491
Fax: (815) 381-7498
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 650 S Randall Rd, Algonquin, IL 60102-5944 — (815) 398-9491

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085004557 (IL)

Record details

NPI number1073859401
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 12, 2012
Last updated in NPPESJune 16, 2026
Certification dateJune 16, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Orthomidwest, Pllc — 537 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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