ALYSIA L GREEN (MD) – Sports Medicine (Family Medicine) Physician, NPI 1013124296
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ALYSIA L GREEN (MD)
915 COMMONWEALTH AVE REAR
BOSTON, MA 022151394
Phone: (617) 358-3400
Fax: (617) 358-3710
Type: Location
Hampton Inn, 801, Albany Street, South End, Boston, Suffolk County, Massachusetts, 02118, United States
FL G
BOSTON, MA 021193791
Phone: (617) 414-6034
Type: Mailing
915 Commonwealth Ave Rear
Boston, MA 022151394
Phone: (617) 358-3400
Fax: (617) 358-3710
Type: Location
633 EMERSON ST
EVANSTON, IL 602081394
Phone: (847) 491-8100
Fax: (847) 491-5919
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-09-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240911000063 | I | Family Practice | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 02215)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | MA | |
| - | MA | |
| Sports Medicine, Family Practice | MA | |
| Family Practice | MA | |
| Family Practice | OH | |
| Family Practice | AR | |
| Family Practice | MA | |
| Family Practice | MA | |
| Family Practice | MA | |
| Nurse Practitioner | MA |
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