Amanda Knightly Green, is a medicare enrolled "Nurse Practitioner" physician in Montgomery, Alabama. Her current practice location is
488 Saint Lukes Dr, Montgomery, Alabama. You can reach out to her office (for appointments etc.) via phone at
(334) 288-7808.
Amanda Knightly Green is licensed to practice in Alabama (license number 1-128331) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1508524802.
Physician's Profile
| Full Name | Amanda Knightly Green |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 488 Saint Lukes Dr, Montgomery, Alabama |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1508524802
- Provider Enumeration Date: 12/03/2021
- Last Update Date: 06/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 3577911221
- Enrollment ID: I20231120000438
Medical Identifiers
Medical identifiers for Amanda Knightly Green such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508524802 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208800000X | Urology | 1-128331 (Alabama) | Secondary |
| 363L00000X | Nurse Practitioner | 1-128331 (Alabama) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Knightly Green allows following entities to bill medicare on her behalf.
| Entity Name | Paragon Contracting Services Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1225071459
PECOS PAC ID: 3971417825
Enrollment ID: O20050218000756 |
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| Entity Name | Emergency Services Of Montgomery Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1528310323
PECOS PAC ID: 6608028204
Enrollment ID: O20121205000519 |
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| Entity Name | Rural Urgent Care Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1932586476
PECOS PAC ID: 8820305600
Enrollment ID: O20150910001722 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Knightly Green is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Amanda Knightly Green,
201 Defense Hwy Ste 205,
Annapolis, MD 21401-7096
Ph: (855) 527-7246 | Amanda Knightly Green,
488 Saint Lukes Dr,
Montgomery, AL 36117-7104
Ph: (334) 288-7808 |
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