Jonathan Russell Green, PA-C is a medicare enrolled "Physician Assistant" physician in Baltimore, Maryland. His current practice location is
1800 Orleans St, Baltimore, Maryland. You can reach out to his office (for appointments etc.) via phone at
(410) 955-5000.
Jonathan Russell Green is licensed to practice in Maryland (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1356181531.
Physician's Profile
Full Name | Jonathan Russell Green |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 1800 Orleans St, Baltimore, Maryland |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1356181531
- Provider Enumeration Date: 05/28/2024
- Last Update Date: 08/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 7618417932
- Enrollment ID: I20240912002131
Medical Identifiers
Medical identifiers for Jonathan Russell Green such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1356181531 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | C0009439 (Maryland) | Secondary |
363A00000X | Physician Assistant | (Maryland) | Primary |
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. Jonathan Russell 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 |
Jonathan Russell Green, PA-C 6201 Greenleigh Ave, Middle River, MD 21220-2004 Ph: () - | Jonathan Russell Green, PA-C 1800 Orleans St, Baltimore, MD 21287-0010 Ph: (410) 955-5000 |
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