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JACLYN GREEN
NPI 1114650413
Physician Assistant in Milwaukee, WI

Active since July 05, 2022PECOS EnrolledAccepts Medicare Assignment
1312 E OKLAHOMA AVE, MILWAUKEE, WI 53207(414) 595-4570 Get Directions Write a Review

NPPES record last updated: July 4, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 4, 2024, Jul 5, 2022 (2 updates tracked since 2022).

About Jaclyn Green NPPES

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

JACLYN GREEN (NPI 1114650413) is an individual physician assistant in Milwaukee, Wisconsin, licensed in Wisconsin (7895-23) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS, is affiliated with Ascension Columbia St Mary's Hospital Milwaukee, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1114650413
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJACLYN GREEN
Location Address1312 E OKLAHOMA AVEMilwaukee, WI 53207-2457
Mailing Address1312 E Oklahoma AveMilwaukee, WI 53207-2457 · (414) 595-4570
Phone(414) 595-4570
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJuly 5, 2022
Last NPPES UpdateJuly 4, 20242 updates tracked since enumeration
NPPES CertifiedJuly 4, 2024
✔ NPI 1114650413 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WI · 7895-23
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1312 E OKLAHOMA AVE, Milwaukee, WI 53207
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jaclyn Green is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830638626
PECOS Enrollment IDI20240823003793
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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension Columbia St Mary's Hospital Milwaukee

Acute Care Hospitals · Milwaukee, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520051
Location2323 N Lake DrMilwaukee, WI 53211 · Milwaukee County
Emergency services Birthing friendly

Ascension SE Wisconsin Hospital

Acute Care Hospitals · Milwaukee, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520136
Location5000 W Chambers StMilwaukee, WI 53210 · Milwaukee County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53207 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
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 Jaclyn Green's NPI number?

The NPI number for Jaclyn Green is 1114650413. It was assigned to this individual provider in the NPPES registry on July 5, 2022.

Where is Jaclyn Green located?

Jaclyn Green practices at 1312 E Oklahoma Ave, Milwaukee, WI 53207. The listed phone number is (414) 595-4570.

What is Jaclyn Green's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Jaclyn Green enrolled in Medicare?

Yes. Jaclyn Green is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Jaclyn Green affiliated with any hospitals?

According to CMS data, Jaclyn Green is affiliated with Ascension Columbia St Mary's Hospital Milwaukee and Ascension SE Wisconsin Hospital.

When was this NPI record last updated?

The NPPES record for Jaclyn Green was last updated on July 4, 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.