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

Mrs. Tedean Karissa Green

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1699122630

Mrs. Tedean Karissa Green is an Otolaryngology in Detroit, Michigan. Graduated from Loma Linda University School of Medicine in 2016, 10 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment.

Years since qualifying
10
Trained at
Loma Linda University School of Medicine
In the registry since
2016
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Practice location Address checks out

4201 Saint Antoine St # Uhc Dept OF Otolaryngology-Head And Neck Surgery
Detroit, MI 48201-2153
Phone: (269) 924-9783
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1699122630
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 19, 2016
Last updated in NPPESJuly 1, 2026
Certification dateJuly 1, 2026

Medicare enrollment

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

Medicare specialtyOTOLARYNGOLOGY
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Detroit