OTIS GREEN
NPI 1497326300
Emergency Medicine in Jacksonville, FL

Q: What is Otis Green's NPI number?

The NPI number for Otis Green is 1497326300. It was assigned to this individual provider in the NPPES registry on July 2, 2021.

Q: What is Otis Green's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Otis Green was last updated on March 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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 02, 2021PECOS Enrolled

4201 BELFORT RD, JACKSONVILLE, FL 32216(904) 296-3700 Get Directions Write a Review

NPPES record last updated: March 30, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 30, 2026, Jul 2, 2021 (2 updates tracked since 2021).

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About Otis Green NPPES

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

OTIS GREEN (NPI 1497326300) is an individual emergency medicine provider in Jacksonville, Florida, licensed in Florida (ME180065) and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS, is affiliated with Ascension St Vincent's Riverside, and is a graduate of Morehouse School Of Medicine (2022).

NPPES Registry Identity

NPI1497326300

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameOTIS GREEN

Location Address4201 BELFORT RDJacksonville, FL 32216-1431

Mailing Address1601 Cummins Dr Ste DModesto, CA 95358-6411

Phone(904) 296-3700

Sole ProprietorNo

Medical School CMSMorehouse School Of MedicineGraduated 2022

Enumeration DateJuly 2, 2021

Last NPPES UpdateMarch 30, 20262 updates tracked since enumeration

NPPES CertifiedMarch 30, 2026

✔ NPI 1497326300 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

License✔ Licensed in FL · ME180065

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

4201 BELFORT RD, Jacksonville, FL 32216

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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 (PECOS)

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

PECOS PAC ID4789064429

PECOS Enrollment IDI20260327004150

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 4

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

Ascension St Vincent's Riverside

Acute Care Hospitals · Jacksonville, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100040

Location1 Shircliff WayJacksonville, FL 32204 · Duval County

Emergency services

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100088

Location800 Prudential DrJacksonville, FL 32207 · Duval County

Emergency services Birthing friendly

Ascension St Vincent's Southside

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100307

Location4201 Belfort RdJacksonville, FL 32216 · Duval County

Emergency services Birthing friendly

Ascension St Vincent's Clay County

Acute Care Hospitals · Middleburg, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100321

Location1670 St Vincents WayMiddleburg, FL 32068 · Clay County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32216 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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 20

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

JENNIFER L. MAUZY MD

Emergency Medicine