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

Tanner James Green

Individual provider Physician Assistant · NPI 1093473647

Tanner James Green is a Physician Assistant in Simi Valley, California. Qualified in 2021, 5 years ago. Practices with Ventura Orthopedics Medical Group Inc, a 78-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
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Practice location Address checks out

2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone: (805) 955-6107
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2525 Erringer Rd, Simi Valley, CA 93065-2352 — (805) 527-1404
  • 137 E Thousand Oaks Blvd, Thousand Oaks, CA 91360-5707 — (805) 379-4574

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 60441 (CA)

Record details

NPI number1093473647
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 1, 2021
Last updated in NPPESMarch 27, 2026
Certification dateMarch 27, 2026
Mailing address1203 Flynn Rd Unit 160, Camarillo, CA 93012-6203

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ventura Orthopedics Medical Group Inc — 78 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Simi Valley