Active NPI
Green Healthcare Associates, Inc.
- Family Medicine Physician
- Bryn Mawr, PA
National Provider Identifier
1578731493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD66662L
- Legal business name
- GREEN HEALTHCARE ASSOCIATES, INC.
- Practice address
- 16 N Bryn Mawr Ave
Bryn Mawr, PA 19010-3379 - Phone
- (215) 452-3728
- NPI assigned
- Feb 13, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sean Dennis Green Sr., M.D.
- Title
- Medical Director
- Phone
- (215) 452-3728
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD66662L | PA | Primary |
Addresses
Primary practice location
16 N Bryn Mawr Ave
Bryn Mawr, PA 19010-3379
Mailing address
PO Box 1353
16 N Bryn Mawr Ave
Bryn Mawr, PA 19010-7353
Phone (610) 667-2506
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01824270 | Medicaid | PA |
National Provider Directory
National Provider DirectoryLocations
16 N Bryn Mawr Ave
Unit 1353
Bryn Mawr, PA 19010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1723939200000",
"number": "1578731493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1353",
"address_2": "16 N BRYN MAWR AVE",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190107353",
"telephone_number": "610-667-2506",
"fax_number": "610-667-2508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 N BRYN MAWR AVE",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103379",
"telephone_number": "215-452-3728"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREEN HEALTHCARE ASSOCIATES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-13",
"last_updated": "2024-08-18",
"certification_date": "2024-08-18",
"status": "A",
"authorized_official_last_name": "GREEN",
"authorized_official_first_name": "SEAN",
"authorized_official_middle_name": "DENNIS",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "215-452-3728",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "Sr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "PA",
"license": "MD66662L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01824270",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bryn Mawr, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.