Young Sam Green, MSN, ANP-BC, GNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

305458 Issued in NY

Practice address

2024 Creston Ave
Bronx, NY 10453-4244

Phone

(718) 294-6200

Fax

(718) 294-6259

NPI assigned

Jul 18, 2011

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

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.

• House Calls Medical Group

  • Internal Medicine Physician
  • New York, NY
  • NPI 1518219732
  NPD
• Lyons Medical Care, PLLC

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245415991
  NPD

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1487942959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 CRESTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534244",
            "telephone_number": "718-294-6200",
            "fax_number": "718-294-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 CRESTON AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534244",
            "telephone_number": "718-294-6200",
            "fax_number": "718-294-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "YOUNG",
        "middle_name": "SAM",
        "credential": "MSN, ANP-BC, GNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-18",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "305458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Green
• Sheron R Green, PA
• Steven Efram Green, LMSW
• Valerie Green, RN
• Wendy Green
• Stevi Jessa Greenan, PA-C
• Sharon Greenaway
• Mark Greenbaum, MD
• Simon Greenbaum, MD
• Amy J Greenberg, LMSW

• Adult Health Nurse Practitioner in Bronx, NY
• Providers in Bronx, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.