Individual provider Active NPI

Alexa Kristen Green

  • Acute Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1336701143
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
701227-01 Issued in NY
Practice address
175 E 96TH St Apt 9C
New York, NY 10128-6204
Phone
(914) 391-4543
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 701227-01 NY Primary

Addresses

Primary practice location

175 E 96TH St Apt 9C
New York, NY 10128-6204

Mailing address

175 E 96TH St Apt 9C
New York, NY 10128-6204
Phone (914) 438-9846

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
I20200401002967 NY Practitioner - Nurse Practitioner 8426487075 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
701227-01NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Anesthesiology Group CurrentSince Jan 1, 2020 Accepting new patients
North Shore-Lij Medical PC CurrentSince Dec 3, 2020 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1336701143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E 96TH ST APT 9C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101286204",
            "telephone_number": "914-438-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E 96TH ST APT 9C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101286204",
            "telephone_number": "914-391-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ALEXA",
        "middle_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "701227-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.