Otis Green Iii, ARNP in Jacksonville, FL - Medicare Nurse Practitioner

Otis Green Iii, ARNP is a medicare enrolled "Nurse Practitioner - Family" in Jacksonville, Florida. His current practice location is 1215 Dunn Ave, Jacksonville, Florida. You can reach out to his office (for appointments etc.) via phone at (904) 757-1998.

Otis Green Iii is licensed to practice in Florida (license number 9344018) 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 1629561451.

Contact Information

	Otis Green Iii, ARNP
	1215 Dunn Ave, Jacksonville, FL 32218-6330
	(904) 757-1998
	(904) 696-7462

Map and Direction

Provider's Profile

Full Name	Otis Green Iii
Gender	Male
Speciality	Nurse Practitioner - Family
Location	1215 Dunn Ave, Jacksonville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1629561451
Provider Enumeration Date: 06/06/2018
Last Update Date: 12/12/2018

Medicare PECOS Information:

PECOS PAC ID: 5890046791
Enrollment ID: I20180914001746

Medical Identifiers

Medical identifiers for Otis Green Iii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1629561451	NPI	-	NPPES
ARNP9344018	Other	FL	ARNP LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	9344018 (Florida)	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. Otis Green Iii allows following entities to bill medicare on his behalf.

Entity Name	University Of Florida Jacksonville Physicians, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144276452 PECOS PAC ID: 9133025869 Enrollment ID: O20040128000786

Entity Name	University Of Florida Jacksonville Physicians, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326208695 PECOS PAC ID: 9133025869 Enrollment ID: O20040204000616

Entity Name	University Of Florida Jacksonville Physicians, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487814752 PECOS PAC ID: 9133025869 Enrollment ID: O20050414000212

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. Otis Green Iii 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
Otis Green Iii, ARNP 6520 Fort Caroline Rd, Jacksonville, FL 32277-2044 Ph: (904) 745-3618	Otis Green Iii, ARNP 1215 Dunn Ave, Jacksonville, FL 32218-6330 Ph: (904) 757-1998

Reviews and Comments

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Otis Green Iii, ARNP - Medicare Nurse Practitioner in Jacksonville, FL