JESSE NATHAN GREENE – Family Medicine Physician, NPI 1477130615

JESSE NATHAN GREENE is a healthcare provider. based in Moultrie, Georgia. specializing in FAMILY PRACTICE. They hold a License No. 100174 (GA). The NPI Number for JESSE NATHAN GREENE is 1477130615

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
JESSE NATHAN GREENE
NPI
1477130615
Phone
Not provided
Address
1 MAGNOLIA CT
Enumeration Date
25 March 2021
Last Update Date
5 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2293772002
Graduation Year
2021 (5 years ago)
PAC ID
4789115924
Group Practice PAC ID
7618067042
Professional Enrollment ID
I20240930001345
Address ID
GA398283141CA1178XSEXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,102 FAMILY PRACTICE in GA

Provider Addresses for JESSE NATHAN GREENE

  • 1 MAGNOLIA CT

    MOULTRIE, GA 317686764

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 4 Open Payments records for all available years, with a total value of $75.

Total Amount is formed as General ($75) + Research ($0) + Ownership ($0) = $75.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Sumitomo Pharma America, Inc. ($22).

Total Amount

$75

General + Research + Ownership

Payments

4

Total payment records

General Amount

$75

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

Latest reported date

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: 2024-09-30

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
I20240930001345IFamily PracticeGATBD

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 31768)

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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: 7618067042View full group profile
NameSpecialtyState
Physician AssistantGA
Nurse PractitionerGA
O B S T E T R I C S/ G Y N E C O L O G YGA
Family PracticeGA
O B S T E T R I C S/ G Y N E C O L O G YGA
Obstetrics/Gynecology, Pediatric Medicine, Family PracticeGA
Family PracticeGA

Reviews

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Frequently asked questions

What federal number belongs to JESSE NATHAN GREENE?
The federal identifier for JESSE NATHAN GREENE is NPI 1477130615.
Does this profile mean JESSE NATHAN GREENE is currently active?
Yes — JESSE NATHAN GREENE appears active in the national provider directory.
Does JESSE NATHAN GREENE list a primary specialty?
If you are matching referrals, note Family Medicine Physician for JESSE NATHAN GREENE. Clinical services aligned with this taxonomy classification.
Where is JESSE NATHAN GREENE's primary listing?
We display Moultrie, Georgia because that is what the record indicates for JESSE NATHAN GREENE.
Is JESSE NATHAN GREENE a real provider?
This page reflects official NPPES data for NPI 1477130615. Always confirm identity and privileges with the practice and licensing boards.

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