Individual provider Active NPI

Tasaine Green

  • Psychiatric/Mental Health Nurse Practitioner
  • Pine Hill, NJ
National Provider Identifier
1124994843
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11042535 Issued in FL
Practice address
98 Estates Rd
Pine Hill, NJ 08021-6567
Phone
(347) 582-4944
NPI assigned
Oct 13, 2025
Last updated
Oct 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11042535 FL Primary

Addresses

Primary practice location

98 Estates Rd
Pine Hill, NJ 08021-6567

Mailing address

98 Estates Rd
Pine Hill, NJ 08021-6567
Phone (347) 582-4944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20260202001011 NY Practitioner - Nurse Practitioner 7416435383 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Fordham University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shakespeare Operating LLCGroup PAC ID 0840604310, 144 clinicians
Thrive Wellness and Recovery IncGroup PAC ID 7012133390, 10 clinicians

Practice addresses (Care Compare)

1250 Shakespeare Ave
Bronx, NY 10452-3012
Phone (646) 350-1633

611 W Main St
Watertown, NY 13601-1337
Phone (315) 788-1530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11042535FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nysarc Inc. CurrentSince Jan 7, 2026 Accepting new patients

Locations

701 Lenox Ave
Oneida, NY 13421
Phone (315) 363-3389

Organizations & group practices 4

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": "1760313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1124994843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 ESTATES RD",
            "city": "PINE HILL",
            "state": "NJ",
            "postal_code": "080216567",
            "telephone_number": "347-582-4944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 ESTATES RD",
            "city": "PINE HILL",
            "state": "NJ",
            "postal_code": "080216567",
            "telephone_number": "347-582-4944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TASAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11042535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Hill, NJ

Sources for this page

Verify at the official NPI Registry.