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

Mallory Ann Green

Individual provider Medical Physician Assistant · NPI 1669127239

Mallory Ann Green is a Physician Assistant in Rochester, New York. Qualified in 2022, 4 years ago. Practices with Western New York Medical Practice PC, a 528-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
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Practice location Address checks out

222 Alexander St
Rochester, NY 14607-4039
Phone: (585) 922-8003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 029112 (NY)

Record details

NPI number1669127239
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedFebruary 13, 2022
Last updated in NPPESFebruary 28, 2023
Certification dateFebruary 28, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Western New York Medical Practice Pc — 528 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Rochester