NPIMap

Individual provider Active NPI

Alexandra Green, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • La Jolla, CA
National Provider Identifier
1679990899
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
A139791 Issued in CA
Practice address
10666 N Torrey Pines Rd
La Jolla, CA 92037-1027
Phone
(858) 554-6158
Fax
(858) 554-6565
NPI assigned
Mar 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X A139791 CA Primary

Addresses

Primary practice location

10666 N Torrey Pines Rd
La Jolla, CA 92037-1027

Mailing address

10790 Rancho Bernardo Rd.
San Diego, CA 92127-5705
Phone (858) 554-6158

Other practice location 1

4150 V St
#1100
Sacramento, CA 95817-1460
Phone (916) 734-2737

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200915001209 PA Practitioner - Emergency MedicinePractitioner - Internal Medicine 2264722248 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Temple University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

3322 N Broad St
Philadelphia, PA 19140-5185
Phone (210) 707-1800

Hospital & facility affiliations

  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A139791CAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Apr 1, 2023 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Apr 1, 2023 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Main Line Healthcare CurrentSince Sep 14, 2020 Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

10790 Rancho Bernardo Rd
San Diego, CA 92127
Phone (858) 554-2626

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

255 W Lancaster Ave
Ste 231
Paoli, PA 19301
Phone (610) 560-8940

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

3500 N Broad St
#1A
Philadelphia, PA 19140

3322 N Broad St
Philadelphia, PA 19140
Phone (215) 707-4000

Interoperability endpoints

  • Direct secure messaging: agreen37057@scrippshlth.medalliesdirect.net

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679990899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD.",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-554-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10666 N TORREY PINES RD",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371027",
            "telephone_number": "858-554-6158",
            "fax_number": "858-554-6565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 V St",
            "address_2": "#1100",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958171460",
            "country_code": "US",
            "telephone_number": "916-734-2737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ALEXANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A139791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

Verify at the official NPI Registry.