Nichole Green, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

008480 Issued in NY

Practice address

535 Main St
Olean, NY 14760-1513

Phone

(716) 372-0141

Fax

(716) 372-6421

NPI assigned

Aug 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Olean Medical Practice PLLC

  • Clinic/Center
  • Salamanca, NY
  • NPI 1285384412
  Medicare reassignment
• General Physician, PC

  • Multi-Specialty Clinic/Center
  • Olean, NY
  • NPI 1679223366
  NPD
• Olean Medical Group

  • Multi-Specialty Clinic/Center
  • Olean, NY
  • NPI 1598158164
  NPD
• Olean General Hospital

  • General Practice Physician
  • Bradford, PA
  • NPI 1649296781

  Physician Assistant

  NPD
• General Physician, PC

  • General Practice Physician
  • Dunkirk, NY
  • NPI 1093959322
  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329350400000",
    "number": "1376535393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601513",
            "telephone_number": "716-372-0141",
            "fax_number": "716-372-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 MAIN ST",
            "city": "OLEAN",
            "state": "NY",
            "postal_code": "147601513",
            "telephone_number": "716-372-0141",
            "fax_number": "716-372-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "NICHOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-16",
        "last_updated": "2012-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brennan Grady, DPT
• Great Lakes Hearing Services Inc
• Great Lakes Otolaryngology PC
• Hallie Green, LMHC
• Matthew Green
• Paul Thomas Green, PHARM.D.
• Heather Rayee Greenawalt, LCSW
• Arthur S Greene, M.D.
• Pamela W. Groth, CCC-LSLP
• Donald P Grzankowski, OD

• Physician Assistant in Olean, NY
• Providers in Olean, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.