Individual provider Active NPI

Lynn B Bernal-Green, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • New Orleans, LA
National Provider Identifier
1508858150
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
L015762 Issued in LA
Practice address
1401 Foucher St
New Orleans, LA 70115
Phone
(504) 897-8418
NPI assigned
Aug 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X L015762 LA Primary

Addresses

Primary practice location

1401 Foucher St
New Orleans, LA 70115

Mailing address

PO Box 62755
New Orleans, LA 70162-2755
Phone (985) 785-2221

Other identifiers 1

IdentifierTypeStateIssuer
1924521MedicaidLA

Other names 1

  • Lynn B Green Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100811000558 LA Practitioner - Pathology 4082711742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1990 Industrial Blvd
Houma, LA 70363-7055
Phone (985) 868-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15762LAMDPharmacist
L015762LAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Louisiana Medical Associates Anatomic Pathology & Clinical Pathology CurrentSince Sep 11, 2019 Accepting new patients
South Louisiana Medical Associates CurrentSince Sep 11, 2019 Accepting new patients
Thibodaux Regional Network Development Corporation Current Accepting new patients
Prytania Pathology Associates LLC Anatomic Pathology & Clinical Pathology Past Accepting new patients
Thibodaux Regional Network Development Corporation Past Accepting new patients

Locations

1990 Industrial Blvd
Houma, LA 70363
Phone (985) 868-9300

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1508858150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62755",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701622755",
            "telephone_number": "985-785-2221",
            "fax_number": "985-785-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 FOUCHER ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70115",
            "telephone_number": "504-897-8418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNAL-GREEN",
        "first_name": "LYNN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "LA",
            "license": "L015762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1924521",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "GREEN",
            "middle_name": "B",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.