Individual provider Active NPI

Maureen Caroline Lilly, MS, RDN

  • Registered Dietitian
  • Kirkland, WA
National Provider Identifier
1124641527
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI60423002 Issued in WA
Practice address
620 5TH Ave S Ste 200
Kirkland, WA 98033-6736
Phone
(425) 814-5100
Fax
(425) 814-5103
NPI assigned
May 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI60423002 WA Primary

Addresses

Primary practice location

620 5TH Ave S Ste 200
Kirkland, WA 98033-6736

Mailing address

PO Box 741515
Los Angeles, CA 90074-1515
Phone (206) 515-5811

Other practice location 1

13244 NE 40th St
Bellevue, WA 98005-1468
Phone (406) 207-0224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124002618 WA Practitioner - Registered Dietitian Or Nutrition Professional 2062865207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

11800 NE 128TH St
Suite 300
Kirkland, WA 98034-7211
Phone (425) 821-8004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DI60423002WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center CurrentSince Jan 5, 2024 Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Dietitian, Registered CurrentSince Jan 5, 2024 Accepting new patients

Locations

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

620 5th Ave S
Ste 200
Kirkland, WA 98033
Phone (425) 814-5100

11800 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 814-5100

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1124641527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741515",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900741515",
            "telephone_number": "206-515-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 5TH AVE S STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336736",
            "telephone_number": "425-814-5100",
            "fax_number": "425-814-5103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13244 NE 40th St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980051468",
            "country_code": "US",
            "telephone_number": "406-207-0224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLY",
        "first_name": "MAUREEN",
        "middle_name": "CAROLINE",
        "credential": "MS, RDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60423002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.