Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicole E Green, PA-C

Individual provider Medical Physician Assistant · NPI 1053873786

Nicole E Green, PA-C is a Physician Assistant in Bel Air, Maryland. Qualified in 2019, 7 years ago. Practices with Agape Physical Therapy and Sports Rehabilitation LP, a 677-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
7
Licensed in
MD
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

500 Uppr Chesapeake DR
Bel Air, MD 21014-4324
Phone: (443) 643-1500
Fax: (443) 643-1505
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence C0007198 (MD)

Record details

NPI number1053873786
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 2, 2019
Last updated in NPPESNovember 3, 2022
Certification dateNovember 3, 2022
Mailing address500 Upper Chesapeake Dr, Bel Air, MD 21014-4324

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Agape Physical Therapy And Sports Rehabilitation Lp — 677 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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