Individual provider · Type 1 NPI

Michael Matthew Green, DO

Pediatric Rehabilitation Medicine Physician · Boise, ID

NPI number 1063665719 Active

Practice location

305 E Jefferson St
Boise, ID 83712-6231

Call (208) 381-5111 Map

Fax (208) 381-5112

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice locations

  • 81 N Mario Capecchi Dr, Department Of Pediatrics, Salt Lake City, UT 84113-1125 · (801) 213-7737

Specialties and licenses

TaxonomyCodeLicense
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician 2081P0301X8728465-1204 (UT)
Pediatric Rehabilitation Medicine Physician 2081P0010X2011017820 (MO)
Pediatric Rehabilitation Medicine Physician 2081P0010X8728465-1204 (UT)
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Pediatric Rehabilitation Medicine Physician Primary 2081P0010XO-1557 (ID)
Physical Medicine & Rehabilitation Physician 208100000XBP10031712 (TX)

Pediatric Rehabilitation Medicine Physician: A physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabi…

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About NPI 1063665719

Michael Matthew Green, DO's National Provider Identifier is 1063665719, issued on Oct 28, 2008. The primary taxonomy on file is Pediatric Rehabilitation Medicine Physician (2081P0010X), and the practice location is in Boise, ID. The record was last updated on Sep 22, 2026.