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GEORGIAN GREEN NP
NPI 1063251627
Nurse Practitioner - Family in Aldan, PA

Active since May 23, 2024PECOS Enrolled
400 W MAGNOLIA AVE, ALDAN, PA 19018(267) 648-8800 Get Directions Write a Review

NPPES record last updated: May 23, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Georgian Green Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GEORGIAN GREEN NP (NPI 1063251627) is an individual family provider in Aldan, Pennsylvania, licensed in Pennsylvania (SP029754) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1063251627
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameGEORGIAN GREENCredential: NP
Location Address400 W MAGNOLIA AVEAldan, PA 19018-3707
Mailing Address400 W Magnolia AveAldan, PA 19018-3707
Phone(267) 648-8800
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateMay 23, 2024
NPPES CertifiedMay 22, 2024
✔ NPI 1063251627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in PA · SP029754
400 W MAGNOLIA AVE, Aldan, PA 19018
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Georgian Green Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2264939628
PECOS Enrollment IDI20251010000404
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Georgian Green reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Penn-Medical Group
4.9 mi
Hematology & Oncology
3400 CIVIC CENTER BLVD, 2ND FLOOR
Philadelphia, PA 19104
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 373 clinicians in this Medicare group
NPI 1679677975 (215) 615-5858

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19018 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.69 typical visit price
range $59.88 – $180.99
Typical copayment $23.17 (range $14.97 – $45.24)
Most-billed visit code 99203
Established Patient
$105.21 typical visit price
range $19.30 – $147.29
Typical copayment $26.30 (range $4.82 – $36.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Georgian Green's NPI number?

The NPI number for Georgian Green is 1063251627. It was assigned to this individual provider in the NPPES registry on May 23, 2024.

Where is Georgian Green located?

Georgian Green practices at 400 W Magnolia Ave, Aldan, PA 19018. The listed phone number is (267) 648-8800.

What is Georgian Green's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Georgian Green enrolled in Medicare?

Yes. Georgian Green is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Georgian Green's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Georgian Green reassigns Medicare benefits to University Of Penn-Medical Group (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Georgian Green's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Georgian Green was last updated on May 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.