Tiffiny Shantay Green, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2023061499 Issued in NJ

Practice address

417 Warren St Unit 373
Beverly, NJ 08010-1100

Phone

(609) 227-1970

NPI assigned

Jan 10, 2014

Last updated

Mar 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Mind Your MindGroup PAC ID 6002242690, 22 clinicians

Diamond Valley Behavioral LLCGroup PAC ID 2466831615, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

86.37 of 100Reported as group

Quality

70.23

Promoting interoperability

100

Improvement activities

40

Cost

77.22

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tiffiny.green.p3@direct.ppncsnj.nextgenshare.com

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.

• Diamond Valley Behavioral LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Burlington City, NJ
  • NPI 1497480081
  Medicare reassignment Care Compare group NPD
• Mind Your Mind

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hamilton, NJ
  • NPI 1053955096
  Medicare reassignment Care Compare group NPD
• Browne Medical, LLC

  • Urgent Care Clinic/Center
  • South Plainfield, NJ
  • NPI 1851733349
  Medicare reassignment NPD
• Immediate Care Medical Walk-in of Hazlet, PA

  • Urgent Care Clinic/Center
  • Hazlet, NJ
  • NPI 1245595313
  Medicare reassignment NPD
• Urgent Care Physicians of New Jersey, LLC

  • Emergency Medicine Physician
  • Red Bank, NJ
  • NPI 1447622402
  Medicare reassignment NPD
• On Demand Urgent Care Group PC

  dba On Demand Urgent Care

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1053729814
  Medicare reassignment NPD
• Diamond Valley Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Burlington, NJ
  • NPI 1073241576
  NPD (past)
• Family Wellness Center PC

  • Family Medicine Physician
  • Middletown, NJ
  • NPI 1427020635
  NPD (past)
• The Radiology Group of New Jersey, LLC

  dba The Medical Group of New Jersey

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  NPD (past)
• On Demand Urgent Care Group PC

  • Urgent Care Clinic/Center
  • Philadelphia, PA
  • NPI 1881083723
  NPD (past)

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1942622915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 WARREN ST UNIT 373",
            "city": "BEVERLY",
            "state": "NJ",
            "postal_code": "080101100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 WARREN ST UNIT 373",
            "city": "BEVERLY",
            "state": "NJ",
            "postal_code": "080101100",
            "telephone_number": "609-227-1970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "427 High St Unit 1823",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NJ",
            "postal_code": "080164585",
            "country_code": "US",
            "telephone_number": "609-496-0285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2083 Klockner Rd",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "NJ",
            "postal_code": "086903415",
            "country_code": "US",
            "telephone_number": "609-222-4902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TIFFINY",
        "middle_name": "SHANTAY",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00685600",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "2023061499",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR15665200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0543934",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dungarvin New Jersey, LLC-Park
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• Sasha Harris
• Mia Haskins
• Jasmine Kiara Jackson, MS.ED., LMHC, LPC
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• National Mentor Healthcare, LLC (New Jersey MENTOR)

• Psychiatric/Mental Health Nurse Practitioner in Beverly, NJ
• Providers in Beverly, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.