Katie E Green, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00367400 Issued in NJ

Practice address

457 Jack Martin Blvd.
Brick, NJ 08724

Phone

(732) 840-7500

Fax

(732) 840-2088

NPI assigned

Aug 23, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Katie E. Krupke Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Owen Carolan MD LLCGroup PAC ID 3870683634, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ocean Medical Center Hospital, Brick, NJ, CCN 310052

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Owen Carolan MD LLC

  • Family Medicine Physician
  • Brick, NJ
  • NPI 1437341526
  Medicare reassignment Care Compare group
• Rothman Orthopaedics of New Jersey, LLC

  • Orthopaedic Surgery Physician
  • Marlton, NJ
  • NPI 1215978630
  Medicare reassignment NPD
• Malek Medical PC

  • Internal Medicine Physician
  • W Long Branch, NJ
  • NPI 1205873601
  Medicare reassignment
• Rothman Institute of New Jersey, P.a.

  • Prosthetic/Orthotic Supplier
  • Manahawkin, NJ
  • NPI 1831611243
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Brick, NJ
  • NPI 1477065126
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Brick, NJ
  • NPI 1942927538

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1679853634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 JACK MARTIN BLVD.",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08724",
            "telephone_number": "732-840-7500",
            "fax_number": "732-840-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 JACK MARTIN BLVD.",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08724",
            "telephone_number": "732-840-7500",
            "fax_number": "732-840-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KATIE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "014932-1",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00367400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "KRUPKE",
            "middle_name": "E.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patricia Grassi, MS, CCC-A; FAAA
• Daniel Joseph Grasso, DMD
• Katherine Grasso, NP
• Joseph A Grauso, D.C.
• Great Atlantic & Pacific Tea Company Inc
• Alexandra Greenberg, D.O.
• Buna Greenblatt
• Abigail Greene, MSW
• Nina Josephine Greene, LAC
• Sarah Elizabeth Grogan, OTR/L

• Physician Assistant in Brick, NJ
• Providers in Brick, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.