Individual provider Active NPI

Keith D Lillemoe

  • Surgery Physician
  • Baltimore, MD
National Provider Identifier
1215982467
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
D0024521 Issued in MD
Practice address
1800 Orleans St
Baltimore, MD 21287-0010
Phone
(410) 502-2037
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 247458 MA
Specialist 174400000X 1058276A IN
Surgery Physician 208600000X D0024521 MD Primary

Addresses

Primary practice location

1800 Orleans St
Baltimore, MD 21287-0010

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 955-5000

Other practice location 1

545 Barnhill Dr
Em 523
Indianapolis, IN 46202-5112
Phone (317) 274-3086

Other identifiers 1

IdentifierTypeStateIssuer
200460210MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Johns Hopkins University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1058276AINMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Surgery CurrentSince Jun 23, 2011 Accepting new patients
The General Hospital Corporation CurrentSince Jun 23, 2011 Accepting new patients
University General Surgeons, Inc. Surgery Past Accepting new patients
University Surgeons, Inc. Specialist Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

15 Parkman St
Boston, MA 02114
Phone (617) 726-3023

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1215982467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-955-5000",
            "fax_number": "410-500-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 ORLEANS ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870010",
            "telephone_number": "410-502-2037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "545 Barnhill Dr",
            "address_2": "EM 523",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025112",
            "country_code": "US",
            "telephone_number": "317-274-3086",
            "fax_number": "317-278-1886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLEMOE",
        "first_name": "KEITH",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "247458",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "1058276A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0024521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200460210",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.