JACKSONVILLE ENT SURGERY CENTER
NPI 1457600769
Otolaryngology in Jacksonville, FL
About Jacksonville Ent Surgery Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSONVILLE ENT SURGERY CENTER (NPI 1457600769) is a healthcare organization registered as an otolaryngology in Jacksonville, Florida and active in the NPI registry since August 2012. The organization lists Charles C Greene, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jacksonville Ent Surgery Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Jacksonville Ent Surgery Center, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
Jacksonville, FL 32256
Jacksonville, FL 32256
St Petersburg, FL 33701
St Louis, MO 63110
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Charles C Greene MD Phd PA's NPI number?
The NPI number for Charles C Greene MD Phd PA is 1457600769. It was assigned to this organization in the NPPES registry on August 31, 2012. The provider is doing business as Jacksonville Ent Surgery Center.
Where is Charles C Greene MD Phd PA located?
Charles C Greene MD Phd PA is located at 11512 Lake Mead Ave Ste 531, Jacksonville, FL 32256. The listed phone number is (904) 419-2054.
What is Charles C Greene MD Phd PA's specialty?
The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.
Is Charles C Greene MD Phd PA enrolled in Medicare?
Yes. Charles C Greene MD Phd PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Charles C Greene MD Phd PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Charles C Greene MD Phd PA. A 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 the clinician's services. The largest specialties are Otolaryngology (4), Nurse Practitioner (3) and Dermatology (1). Of these, 2 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Charles C Greene MD Phd PA accept?
Health plans from AvMed and Molina Healthcare list Charles C Greene MD Phd PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Charles C Greene MD Phd PA was last updated on August 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Jacksonville Ent Surgery Center · NPI 1457600769
Otolaryngology organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since August 31, 2012.
## Identity
- **NPI:** 1457600769 (Entity type: Organization)
- **Enumerated:** August 31, 2012
- **Primary specialty:** Otolaryngology · taxonomy 207Y00000X
- **Legal business name:** Charles C Greene Md Phd Pa
- **Organization subpart:** No
- **Authorized official:** Charles Greene, OWNER
## Practice location
- **Address:** 11512 LAKE MEAD AVE, STE 531, Jacksonville, FL 32256-9733
- **Phone:** (904) 419-2054 · **Fax:** (904) 419-2057
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Otolaryngology (4), Nurse Practitioner (3), Dermatology (1); 2 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 3, 2022
- **Other identifiers:** Medicaid 008103800 (FL); Other 003PF (FL)
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Source: [NPI Profile](https://npiprofile.com/npi/1457600769) · Data from the CMS NPPES public registry.