Active NPI
Nathaniel Green, MD
- Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1750877197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MT217003
- Practice address
- 5501 Old York Rd.
Levy Building, 2F C/O Coretta Philgence
Philadelphia, PA 19141 - Phone
- (215) 456-7595
- NPI assigned
- Jul 9, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MT217003 | PA | Primary |
Addresses
Primary practice location
5501 Old York Rd.
Levy Building, 2F C/O Coretta Philgence
Philadelphia, PA 19141
Mailing address
PO Box 270
Emporium, PA 15834-0270
Phone (202) 468-8804
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT217003 | PA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625097600000",
"number": "1750877197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 270",
"city": "EMPORIUM",
"state": "PA",
"postal_code": "158340270",
"telephone_number": "202-468-8804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5501 OLD YORK RD.",
"address_2": "LEVY BUILDING, 2F C/O CORETTA PHILGENCE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19141",
"telephone_number": "215-456-7595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "NATHANIEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-09",
"last_updated": "2021-07-01",
"certification_date": "2021-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MT217003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.