ASHLEY GREEN (PA-C, RD, LD/N) – Physician Assistant, NPI 1205443728

ASHLEY GREEN (PA-C, RD, LD/N) is a healthcare provider. based in Orange city, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C, RD, LD/N. They hold a License No. ND7124 (FL). The NPI Number for ASHLEY GREEN (PA-C, RD, LD/N) is 1205443728

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
ASHLEY GREEN (PA-C, RD, LD/N)
NPI
1205443728
Phone
(386) 777-2273
Address
1639 N Volusia Ave Ste B
Enumeration Date
29 September 2020
Last Update Date
7 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3867740016
Graduation Year
2020 (6 years ago)
PAC ID
8022425693
Group Practice PAC ID
1456483098
Professional Enrollment ID
I20210326000451
Address ID
FL327633843OR1639XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

9,232 PHYSICIAN ASSISTANT in FL

Provider Addresses for ASHLEY GREEN (PA-C, RD, LD/N)

  • 1639 N Volusia Ave Ste B

    Orange City, FL 327633843

    Phone: (386) 777-2273

    Type: Location

  • 1277 SW BRIARWOOD DR

    PORT SAINT LUCIE, FL 349862307

    Phone: (772) 834-7342

    Type: Mailing

  • 3675 SIMONTON PL

    LAKE MARY, FL 327466752

    Phone: (772) 834-7342

    Type: Mailing

  • 1301 S INTERNATIONAL PKWY STE 1041

    LAKE MARY, FL 327461410

    Phone: (407) 732-7668

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $56.

Total Amount is formed as General ($56) + Research ($0) + Ownership ($0) = $56.

Last reported payment date: 2024-09-23 • Largest payer in this snapshot: Lilly USA, LLC ($33).

Total Amount

$56

General + Research + Ownership

Payments

2

Total payment records

General Amount

$56

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-23

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Lilly USA, LLC$33
Amgen Inc.$23
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-03-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210326000451IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32763)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1456483098View full group profile
NameSpecialtyState
Internal Medicine, Sports MedicineFL
Physician AssistantFL
Nurse PractitionerFL
Internal MedicineOK
Physician AssistantFL
Family PracticeFL
Family PracticeFL
Nurse PractitionerFL
Family PracticeFL
Nurse PractitionerKY

Reviews

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Frequently asked questions

Can I cross-check ASHLEY GREEN (PA-C, RD, LD/N) using NPI 1205443728?
NPI 1205443728 belongs to ASHLEY GREEN (PA-C, RD, LD/N); compare other details if you need extra assurance.
Is there an active status for ASHLEY GREEN (PA-C, RD, LD/N)?
For scheduling context, ASHLEY GREEN (PA-C, RD, LD/N) is shown as active in the registry.
What clinical focus is listed for ASHLEY GREEN (PA-C, RD, LD/N)?
At a glance, ASHLEY GREEN (PA-C, RD, LD/N) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ASHLEY GREEN (PA-C, RD, LD/N)?
Travel planning: use Orange City, Florida as the reference point for ASHLEY GREEN (PA-C, RD, LD/N), then confirm.
When was this NPI issued?
Enumeration for ASHLEY GREEN (PA-C, RD, LD/N) is noted as September 29, 2020 where the registry provides it.

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