NPIMap

Organization Active NPI

Lisa Green Physical Therapy, PC

  • Orthopedic Physical Therapist
  • Portola Valley, CA
National Provider Identifier
1376246470
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
LISA GREEN PHYSICAL THERAPY, PC
Practice address
108 Portola Rd
Portola Valley, CA 94028-7825
Phone
(650) 851-1145
Fax
(650) 851-9251
NPI assigned
Mar 27, 2023
Last updated
Mar 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Lisa Green, PT, MOMT, MPT, ATCNPI 1528193240
Title
President
Phone
(650) 851-1145

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X NU
Orthopedic Physical Therapist 2251X0800X NU Primary

Addresses

Primary practice location

108 Portola Rd
Portola Valley, CA 94028-7825

Mailing address

108 Portola Rd
Portola Valley, CA 94028-7825
Phone (650) 851-1145

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1376246470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 PORTOLA RD",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287825",
            "telephone_number": "650-851-1145",
            "fax_number": "650-851-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 PORTOLA RD",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940287825",
            "telephone_number": "650-851-1145",
            "fax_number": "650-851-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA GREEN PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-25",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-851-1145",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT, MOMT, MPT, ATC"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portola Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.