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

Individual provider Physician Assistant · NPI 1538769633

Mr. Brenton Michael Green, PA-C is a Physician Assistant in Bismarck, North Dakota. Qualified in 2020, 6 years ago. Practices with St Alexius Medical Center, a 241-clinician group and accepts Medicare assignment. Licensed in North Dakota.

Years since qualifying
6
Licensed in
ND
In the registry since
2020
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

900 E Broadway Ave
Bismarck, ND 58501-4520
Phone: (701) 530-7000
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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 PAC0858 (ND)

Record details

NPI number1538769633
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 28, 2020
Last updated in NPPESOctober 28, 2020
Certification dateOctober 28, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice St Alexius Medical Center — 241 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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