Organization Active NPI

Green NP in Adult Health PLLC

  • Nurse Practitioner
  • Poughkeepsie, NY
National Provider Identifier
1457083388
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
GREEN NP IN ADULT HEALTH PLLC
Practice address
1 Bushwick Rd Ste C
Poughkeepsie, NY 12603-3839
Phone
(845) 579-3435
Fax
(845) 243-2100
NPI assigned
Jun 29, 2022
Last updated
Apr 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Authorized official

Name
Patricia Monge O'Connell, NPNPI 1982145769
Title
Owner
Phone
(845) 579-3435

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

1 Bushwick Rd Ste C
Poughkeepsie, NY 12603-3839

Mailing address

1 Bushwick Rd Ste C
Poughkeepsie, NY 12603-3839
Phone (845) 579-3435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220722001241 NY Part B Supplier - Clinic/Group Practice 4385025295 Receives reassigned benefits from 8 practitioners
Practice locations: Highland, NY; Poughkeepsie, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2309767Green NP in Adult Health, PLLC1 Bushwick Rd Suite C, Poughkeepsie, NY 12603Certificate of waiverAug 20, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1457083388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BUSHWICK RD STE C",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126033839",
            "telephone_number": "845-579-3435",
            "fax_number": "845-243-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BUSHWICK RD STE C",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126033839",
            "telephone_number": "845-579-3435",
            "fax_number": "845-243-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN NP IN ADULT HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-29",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "O'CONNELL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "MONGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-579-3435",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.