Stacy Jo Green, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP010692 Issued in PA

Practice address

120 Washington Towne Blvd N
Edinboro, PA 16412-1254

Phone

(814) 877-7500

Fax

(814) 877-7510

NPI assigned

Feb 8, 2010

Last updated

Aug 10, 2021By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regional Health Services IncGroup PAC ID 4880593722, 572 clinicians

Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Upmc Hamot Hospital, Erie, PA, CCN 390063
• Meadville Medical Center Hospital, Meadville, PA, CCN 390113

Merit-based Incentive Payment System (MIPS)

Final score

81.89 of 100Reported as group

Quality

65.8

Promoting interoperability

100

Improvement activities

40

Cost

73.83

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Regional Health Services Inc

  • Family Medicine Physician
  • Erie, PA
  • NPI 1174520654
  Medicare reassignment Care Compare group NPD
• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1538207394
  NPD (past)

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

• Meadville Medical Center

  • General Acute Care Hospital
  • Meadville, PA
  • NPI 1942276423
  Care Compare affiliation
• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1487647590
  Care Compare affiliation
• Upmc Hamot

  • General Acute Care Hospital
  • Erie, PA
  • NPI 1538207394
  Care Compare affiliation

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1437481074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WASHINGTON TOWNE BLVD N",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164121254",
            "telephone_number": "814-877-7500",
            "fax_number": "814-877-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WASHINGTON TOWNE BLVD N",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164121254",
            "telephone_number": "814-877-7500",
            "fax_number": "814-877-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "STACY",
        "middle_name": "JO",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-08",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP010692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stacy.j.green@upmcdirect.com",
            "affiliation": "N",
            "address_1": "120 Washington Towne Blvd N",
            "city": "Edinboro",
            "state": "PA",
            "country_code": "US",
            "postal_code": "164121254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Allen Gill, FNP
• Rebekah Mae Glander, PHARMD
• Katelyn Goodenow, LPC
• Craig Gourley, MSW , LSW
• Greater Erie Community Action Committee (GECAC D&A Services)
• Steven J Grygier, D.C.
• Mandy L Gwin
• Rachel Jean Hamm Van Valkenberg
• Mimi C Haney, OTR/L
• Gary Robert Hanna, ATC

• Nurse Practitioner in Edinboro, PA
• Providers in Edinboro, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.