Individual provider Active NPI

Maureen M Green, FNP-BC

  • Family Nurse Practitioner
  • Pinellas Park, FL
National Provider Identifier
1073605002
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9446737 Issued in FL
Practice address
4423 Park Blvd N
Pinellas Park, FL 33781-3540
Phone
(727) 827-2825
Fax
(727) 827-2809
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9446737 FL Primary

Addresses

Primary practice location

4423 Park Blvd N
Pinellas Park, FL 33781-3540

Mailing address

4423 Park Blvd N
Pinellas Park, FL 33781-3540
Phone (727) 827-2825

Other practice location 1

50 S Belcher Rd Ste 124
Clearwater, FL 33765-3903
Phone (727) 827-2825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170922000794 FL Practitioner - Nurse Practitioner 8426322959 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
LBH Med Group LLC PastSince Jul 10, 2017 Accepting new patients
Bozena B Sabala DO PA PastSince Jul 10, 2017 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1073605002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4423 PARK BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813540",
            "telephone_number": "727-827-2825",
            "fax_number": "727-827-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 PARK BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813540",
            "telephone_number": "727-827-2825",
            "fax_number": "727-827-2809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 S Belcher Rd Ste 124",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337653903",
            "country_code": "US",
            "telephone_number": "727-827-2825",
            "fax_number": "727-827-2809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MAUREEN",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9446737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

Verify at the official NPI Registry.