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JONATHAN GREEN M.D.
NPI 1720425390
Surgery - Pediatric Surgery in Worcester, MA

Active since May 23, 2013PECOS Enrolled
55 LAKE AVE N, WORCESTER, MA 01655(508) 856-2128(774) 443-2043 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Jun 19, 2020 (2 updates tracked since 2020).

About Jonathan Green M.d. NPPES

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

JONATHAN GREEN M.D. (NPI 1720425390) is an individual pediatric surgery provider in Worcester, Massachusetts, licensed in Massachusetts (262955) and active in the NPI registry since May 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720425390
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameJONATHAN GREENCredential: M.D.
Location Address55 LAKE AVE NWorcester, MA 01655-0002
Mailing AddressPo Box 415348Boston, MA 02241-5348
Phone(508) 856-2128
Fax(774) 443-2043
Sole ProprietorNo
Enumeration DateMay 23, 2013
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
NPPES CertifiedJuly 21, 2022
✔ NPI 1720425390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
Licenses✔ Licensed in MA · 262955✔ Licensed in OK · 35666
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
Also ListedSurgeryTaxonomy 208600000X · License 255779 (MA)
55 LAKE AVE N, Worcester, MA 01655
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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)

Jonathan Green M.d. 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.

HILLARY R. IRONS MD
Emergency Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 421-1400
MS. EILEEN A. DUHAMEL NP
Nurse Practitioner
55 LAKE AVE N, DEPARTMENT OF RADIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-2710
EWA HRYNISZYN CRNA
Nurse Anesthetist, Certified Registered
55 LAKE AVE N, DEPARTMENT OF ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
HELEN COPSEY PA-C
Physician Assistant
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-8585
DR. ADEPEJU GBADEBO CHAMPION M.D.
Internal Medicine
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-2731
SOWMYA KORAPATI
Internal Medicine (Hematology & Oncology)
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-3550
LAYLA FAKHRZADEH M.D.
Anesthesiology
55 LAKE AVE N, ANESTHESIOLOGY
WORCESTER, MA 01655
Worcester County (508) 334-3271
YOONYIE CHO M.D.
Anesthesiology
55 LAKE AVE N
WORCESTER, MA 01655
Worcester County (508) 334-1000

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 Jonathan Green's NPI number?

The NPI number for Jonathan Green is 1720425390. It was assigned to this individual provider in the NPPES registry on May 23, 2013.

Where is Jonathan Green located?

Jonathan Green practices at 55 Lake Ave N, Worcester, MA 01655. The listed phone number is (508) 856-2128.

What is Jonathan Green's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Jonathan Green enrolled in Medicare?

Yes. Jonathan Green is registered in the Medicare PECOS enrollment system.

What insurance does Jonathan Green accept?

Health plans from Anthem Blue Cross and Blue Shield list Jonathan Green 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 Jonathan Green was last updated on July 21, 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.