Individual provider Active NPI

Sydney T'Sara Green, MD

  • Pediatrics Physician
  • Louisville, KY
National Provider Identifier
1871121871
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
59132 Issued in KY
Practice address
231 E Chestnut St
Louisville, KY 40202-1821
Phone
(502) 629-4750
Fax
(502) 629-4617
NPI assigned
Mar 27, 2020
Last updated
Aug 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101279129 VA
Pediatrics Physician 208000000X 59132 KY Primary

Addresses

Primary practice location

231 E Chestnut St
Louisville, KY 40202-1821

Mailing address

PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, KY, FL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230912003074 VA Practitioner - Pediatric Medicine 6103280987 Reassigns benefits to 1 organization
I20250919003169 KY Practitioner - Pediatric Medicine 6103280987 Reassigns benefits to 1 organization
I20260618003558 FL Practitioner - HospitalistPractitioner - Pediatric Medicine 6103280987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Pediatric Medicine
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12901 Bruce B Downs Blvd
Suite 62
Tampa, FL 33612-4799

1951 Bishop LN
FL 4
Louisville, KY 40218-1923

PO Box
Suite 776879
Chicago, IL 60677-6879

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101279129VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Specialty Group PLLC Pediatrics CurrentSince Aug 1, 2023 Accepting new patients
Norton Children's Medical Group, LLC Pediatrics CurrentSince Oct 1, 2025 Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

850 Southampton Ave
Norfolk, VA 23510
Phone (757) 668-4673

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1871121871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021821",
            "telephone_number": "502-629-4750",
            "fax_number": "502-629-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SYDNEY",
        "middle_name": "T'SARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101279129",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "59132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.