Green NP in Adult Health PLLC

Organization Active NPI Nurse Practitioner · Poughkeepsie, NY

NPI 1457083388 · NPPES record last updated Apr 18, 2025

Key facts

NPI
1457083388
Entity type
Organization (NPI type 2)
Primary specialty
Nurse Practitioner 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
Organization subpart
No

Authorized official

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

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

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

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

National Provider Directory

Locations

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363L00000X Yes
Psychiatric/Mental Health Nurse Practitioner
Group: 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

Other identifiers

IdentifierTypeStateIssuer
07468940MedicaidNY

Other providers in Poughkeepsie, NY

All providers in Poughkeepsie, NY · Nurse Practitioner in New York

Sources for this page

Verify at the official NPI Registry.