SHELLIE A GREEN
NPI 1124636113
Nurse Practitioner - Family in Watertown, NY

Q: What is Shellie Green's NPI number?

The NPI number for Shellie Green is 1124636113. It was assigned to this individual provider in the NPPES registry on July 16, 2020. The provider is also known as Shellie A Countryman.

Q: What is Shellie Green's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Shellie Green was last updated on July 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since July 16, 2020PECOS EnrolledAccepts Medicare Assignment

160 STONE ST, WATERTOWN, NY 13601(585) 371-8373(315) 222-7435 Get Directions Write a Review

NPPES record last updated: July 17, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Shellie A Green NPPES

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

SHELLIE A GREEN (NPI 1124636113) is an individual family provider in Watertown, New York, licensed in New York (F346037-1) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS and is a graduate of State University Of Ny Upstate Medical University (2020).

NPPES Registry Identity

NPI1124636113

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSHELLIE A GREEN

Location Address160 STONE STWatertown, NY 13601-3250

Mailing Address2697 Main StBuffalo, NY 14214-1701 · (585) 371-8373

Phone(585) 371-8373

Fax(315) 222-7435

Sole ProprietorNo

Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2020

Enumeration DateJuly 16, 2020

Last NPPES UpdateJuly 17, 2020

NPPES CertifiedJuly 17, 2020

✔ NPI 1124636113 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 NY · F346037-1

160 STONE ST, Watertown, NY 13601

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Other Names 1

Former Name (1)Shellie A Countryman

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

Shellie A 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 ID1951729359

PECOS Enrollment IDI20200917000293

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

178 services117 patients

Cervical or vaginal cancer screening; pelvic and clinical breast examination G0101

This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.

74 services74 patients

Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory Q0091

A Papanicolaou smear, often called a Pap smear, is a test to check for changes in cells. A small sample is gently collected from the lower region and sent to a lab for examination. This helps in early detection of potential health issues.

41 services41 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13601 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RENEE BULL NP

Nurse Practitioner (Family)