Autumn Nicole Greene, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007483 Issued in MI

Practice address

44344 Dequindre Rd Ste 260
Sterling Heights, MI 48314

Phone

(586) 323-1500

Fax

(586) 323-1515

NPI assigned

Sep 29, 2015

Last updated

Apr 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, VA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11357/brand/3/csg/1/fhir/r4

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.

• Centra Medical Group, LLC

  • Family Medicine Physician
  • Lynchburg, VA
  • NPI 1649228966
  Medicare reassignment Care Compare group
• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment
• Michigan Healthcare Professionals PC

  dba Urology Specialist of Michigan

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD
• Michigan Healthcare Professionals, P.C.

  • Physical Therapist
  • Dearborn, MI
  • NPI 1316757446
  NPD
• Centra Health Professional Services, LLC

  dba Forest Women's Center

  • Obstetrics & Gynecology Physician
  • Forest, VA
  • NPI 1922241108
  NPD
• Physician Healthcare Network, PC

  • Urgent Care Clinic/Center
  • Marysville, MI
  • NPI 1093921074
  NPD (past)
• Pro-Health Medical FP

  • Primary Care Clinic/Center
  • Lake Orion, MI
  • NPI 1740841451
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Centra Health Inc

  • General Acute Care Hospital
  • Lynchburg, VA
  • NPI 1770693939
  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba Centra Health Cardiothoracic Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynchburg, VA
  • NPI 1407884448

  Hospital

  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba The Pain Center

  • Pain Medicine (Anesthesiology) Physician
  • Lynchburg, VA
  • NPI 1811925852

  Hospital

  Care Compare affiliation
• Centra Health Professional Services, LLC

  dba The Wound Care Center

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Lynchburg, VA
  • NPI 1902834948

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba CMG Vascular Surgery

  • Vascular Surgery Physician
  • Lynchburg, VA
  • NPI 1144880782

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba Centra Medical Group Stroobants Cardiovascular Center

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lynchburg, VA
  • NPI 1184964124

  Hospital

  Care Compare affiliation
• Centra Medical Group, LLC

  dba Centra Lynchburg Hematology and Oncology

  • Hematology & Oncology Physician
  • Lynchburg, VA
  • NPI 1700293628

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1265802623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44344 DEQUINDRE RD STE 260",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141040",
            "telephone_number": "586-323-1500",
            "fax_number": "586-323-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44344 DEQUINDRE RD STE 260",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48314",
            "telephone_number": "586-323-1500",
            "fax_number": "586-323-1515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53960 Van Dyke Ave",
            "address_purpose": "LOCATION",
            "city": "Shelby Twp",
            "state": "MI",
            "postal_code": "483161820",
            "country_code": "US",
            "telephone_number": "586-323-1500",
            "fax_number": "586-323-1515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE",
        "first_name": "AUTUMN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009956",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Reliable Services LLC
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• Greatlakes Chiropractic
• Astarta Green
• Noah Alan-Donald Green
• Brendan Greene
• Katherine Marie Greening, AU.D.
• Jayla Janae Greer
• Jennifer Gregson, RN
• Avneet Grewal, M.D.

• Physician Assistant in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.