Organization Active NPI

Green Healthcare Associates, Inc.

  • Family Medicine Physician
  • Bryn Mawr, PA
National Provider Identifier
1578731493
Registry record updated Aug 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD66662L Issued in PA
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

Updated by the provider on Aug 18, 2024

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
01824270MedicaidPA

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.