MR. JEFFREY MICHAEL GREEN (PA-C) – Physician Assistant, NPI 1912979584
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for MR. JEFFREY MICHAEL GREEN (PA-C)
11555 CENTRAL PKWY STE 304
JACKSONVILLE, FL 322242694
Phone: (904) 265-7755
Fax: (904) 265-7754
Type: Location
2023 MYRA ST
JACKSONVILLE, FL 322043714
Phone: (904) 503-5464
Fax: (904) 575-4399
Type: Mailing
4745 SUTTON PARK CT STE 501
JACKSONVILLE, FL 322240251
Phone: (904) 503-5464
Fax: (904) 575-4399
Type: Location
2023 Myra St
Jacksonville, FL 322043714
Phone: (904) 503-5464
Fax: (904) 575-4399
Type: Location
705 WELLS RD STE 300
ORANGE PARK, FL 320732982
Phone: (904) 282-6331
Fax: (904) 619-1080
Type: Mailing
1361 13TH AVE S STE 250
JACKSONVILLE, FL 322503238
Phone: (904) 265-7755
Fax: (904) 265-7754
Type: Location
Argyle Forest Boulevard, Argyle Forest, Jacksonville, Duval County, Florida, 32244, United States
JACKSONVILLE, FL 322445597
Phone: (904) 282-6331
Fax: (904) 282-4117
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 42 Open Payments records for all available years, with a total value of $1,221.
Total Amount is formed as General ($1,221) + Research ($0) + Ownership ($0) = $1,221.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Medtronic, Inc. ($541).
Total Amount
$1,221
General + Research + Ownership
Payments
42
Total payment records
General Amount
$1,221
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2007-02-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070212000297 | I | Physician Assistant | FL | TBD |
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.
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 32224)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pain Management | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL |
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