Individual provider Active NPI

Mayona Crisanta Catap Green, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1306699434
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F02240985 Issued in MD
Practice address
2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone
(410) 601-9000
NPI assigned
Apr 9, 2024
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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 F02240985 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Mailing address

4208 Thorncliff Rd
Nottingham, MD 21236-4012
Phone (443) 939-5097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240611000704 MD Practitioner - Nurse Practitioner 3779025317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shawn Dhillon MD PCGroup PAC ID 8527074699, 3 clinicians

Practice addresses (Care Compare)

2 Hamill Rd
Suite 272
Baltimore, MD 21210-1816
Phone (410) 261-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F02240985MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Current Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Jun 17, 2024 Accepting new patients
Sinai Hospital of Baltimore Inc CurrentSince Jun 17, 2024 Accepting new patients
Shawn Dhillon, M.D., P.C. CurrentSince Sep 3, 2024 Accepting new patients
Shawn Dhillon, M.D., P.C. CurrentSince Sep 3, 2024 Accepting new patients
Sinai Hospital of Baltimore Inc Past Accepting new patients

Locations

2 Hamill Rd
Ste 272
Baltimore, MD 21210
Phone (410) 261-8532

2401 W Belvedere Ave
Baltimore, MD 21215

2435 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 601-0900

2435 W Belvedere Ave
Ste 51
Baltimore, MD 21215
Phone (410) 578-5392

Organizations & group practices 6

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": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1306699434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 THORNCLIFF RD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364012",
            "telephone_number": "443-939-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MAYONA CRISANTA",
        "middle_name": "CATAP",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "F02240985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.