Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Lloyd Charles Cassidy IV, MD

Individual provider Family Medicine Physician · NPI 1457795569

Dr. Lloyd Charles Cassidy IV, MD is an Emergency Medicine in Green Bay, Wisconsin. Qualified in 2013, 13 years ago. Practices with St Gianna Molla Clinic, Inc, a 6-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Illinois, Texas and Wisconsin.

Years since qualifying
13
Licensed in
IL, TX, WI
In the registry since
2013
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

124 Siegler St
Green Bay, WI 54303-2636
Phone: (920) 605-3115
Fax: (920) 486-6826
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 2875 W. 19th Street, Chicago, IL 60623 — (773) 484-1000
  • 1500 S Main St, Fort Worth, TX 76104-4917 — (817) 702-1204
  • 100 County Road, Shawano, WI 54166-7072 — (715) 526-2111

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 70125 (WI)
Family Medicine Physician Taxonomy 207Q00000X · Licence 036144493 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence Q6620 (TX)

Record details

NPI number1457795569
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 18, 2013
Last updated in NPPESJanuary 27, 2021
Certification dateJanuary 27, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice St Gianna Molla Clinic, Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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