Lisa Jeannette Green, MD

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

MD489524 Issued in PA

Practice address

6400 Brooktree CT Ste 100&120
Wexford, PA 15090-9271

Phone

(412) 785-1057

NPI assigned

Jun 16, 2010

Last updated

Jun 5, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Prisma Health University Medical Group

  dba Parkside OB-GYN

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Shady Grove Fertility Center of Pennsylvania PLC

  • Reproductive Endocrinology Physician
  • Chesterbrook, PA
  • NPI 1922353366
  NPD (past)
• Shady Grove Reproductive Science Center PC

  dba SGFC Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Rockville, MD
  • NPI 1437232758
  NPD (past)

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1619298460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 BLACKWELL RD STE 500",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503783",
            "telephone_number": "412-785-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 BROOKTREE CT STE 100&120",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909271",
            "telephone_number": "412-785-1057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LISA",
        "middle_name": "JEANNETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "51441",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD489524",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "SC",
            "license": "51441",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "PA",
            "license": "MD489524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Marshall Grady, D.M.D.
• Aaron Grand, MD
• Mallory Grant, M.ED, LPC
• Greater Pittsburgh Chiropractic Centers, Inc.
• Greater Pittsburgh Foot & Ankle Center PC
• Rebecca Elizabeth Green, DPT
• Brittany Elizabeth Greene, MS, RDN, LDN
• Greg Jockel Hair Designers, Inc. (greg jockel hair colour design)
• Sophie Louise Greger, LCSW
• Michael Greisler, PSY.D., LCSW

• Reproductive Endocrinology Physician in Wexford, PA
• Providers in Wexford, PA by specialty
• Reproductive Endocrinology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.