Active NPI
Keith D Lillemoe
- Surgery Physician
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- D0024521
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200460210 | Medicaid | IN |
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
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
- Brigham and Women'S Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Hernia repair - groin (open) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1058276A | IN | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts General Physicians Organization Inc | Surgery | Current | Accepting new patients |
| The General Hospital Corporation | Current | 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.
-
- Dermatology Physician
- Boston, MA
- NPI 1801874573
Surgery
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Surgery Physician
- Indianapolis, IN
- NPI 1811019847
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1790717650
-
- General Acute Care Hospital
- Boston, MA
- NPI 1023049236
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.