DR. KATERINA JANE GREEN MB BCH BAO
NPI 1669161030
Otolaryngology - Plastic Surgery within the Head & Neck in Jacksonville, FL

Q: What is Katerina Green's NPI number?

The NPI number for Katerina Green is 1669161030. It was assigned to this individual provider in the NPPES registry on May 2, 2023.

Q: What is Katerina Green's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

Q: When was this NPI record last updated?

The NPPES record for Katerina Green was last updated on June 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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 May 02, 2023PECOS Enrolled

4500 SAN PABLO RD S, JACKSONVILLE, FL 32224(904) 953-2000 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 13, 2025, Jul 6, 2023, May 2, 2023 (3 updates tracked since 2023).

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About Dr. Katerina Jane Green Mb Bch Bao NPPES

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

DR. KATERINA JANE GREEN MB BCH BAO (NPI 1669161030) is an individual plastic surgery within the head & neck provider in Jacksonville, Florida, licensed in Florida (ME173098) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669161030

Entity TypeIndividualFemale

Primary Taxonomy207YX0007X

Provider Legal NameDR. KATERINA JANE GREENCredential: MB BCH BAO

Location Address4500 SAN PABLO RD SJacksonville, FL 32224-1865

Mailing Address4500 San Pablo Rd SJacksonville, FL 32224-1865 · (904) 953-2000

Phone(904) 953-2000

Sole ProprietorNo

Enumeration DateMay 2, 2023

Last NPPES UpdateJune 13, 20253 updates tracked since enumeration

NPPES CertifiedJune 13, 2025

✔ NPI 1669161030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngology · Plastic Surgery within the Head & NeckAllopathic & Osteopathic Physicians

Taxonomy Code207YX0007X

License✔ Licensed in FL · ME173098

Definition

An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.

Also ListedOtolaryngologyTaxonomy 207Y00000X · License ME173098 (FL)

4500 SAN PABLO RD S, Jacksonville, FL 32224

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Katerina Jane Green Mb Bch Bao is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

KATHERINE L WALSH PA-C/MPH

Physician Assistant