Individual provider Active NPI

Kean B Lawlor, MD

  • Dermatology Physician
  • Seattle, WA
National Provider Identifier
1215985833
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD30728 Issued in WA
Practice address
3216 NE 45TH Place
Ste 203
Seattle, WA 98105
Phone
(206) 525-1168
Fax
(206) 525-1169
NPI assigned
May 5, 2006
Last updated
Sep 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD30728 WA Primary
MOHS-Micrographic Surgery Physician 207ND0101X MD30728 WA
Dermatopathology Physician 207ND0900X MD30728 WA
Procedural Dermatology Physician 207NS0135X MD30728 WA

Addresses

Primary practice location

3216 NE 45TH Place
Ste 203
Seattle, WA 98105

Mailing address

3216 NE 45TH Place
Ste 203
Seattle, WA 98105
Phone (206) 525-1168

Other identifiers 1

IdentifierTypeStateIssuer
1109735MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050405001012 WA Practitioner - Dermatology 4880641513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Missouri, Kansas City, School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Falls Dermatology LLCGroup PAC ID 5890863492, 100 clinicians

Practice addresses (Care Compare)

3216 NE 45TH PL
Suite 203
Seattle, WA 98105-4028
Phone (206) 525-1168

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision134
Removal of tissue1-10
Removal of skin lesions760
Removal of skin cancer645
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy227

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD30728WAMDDermatopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Falls Dermatology, LLC Dermatology CurrentSince Apr 1, 2021 Accepting new patients

Locations

1515 116th Ave NE
Ste 307
Bellevue, WA 98004
Phone (425) 999-2628

21701 76th Ave W
Ste 100
Edmonds, WA 98026
Phone (206) 525-1168

21727 76th Ave W
Ste H
Edmonds, WA 98026
Phone (425) 672-1333

1301 4th Ave NW
Ste 302
Issaquah, WA 98027
Phone (206) 305-9963

1106 Douglas St
Ste F
Longview, WA 98632
Phone (360) 636-4500

1338 Commerce Ave
Ste 106
Longview, WA 98632
Phone (971) 915-8587

8435 SE 68th St
Ste 118
Mercer Island, WA 98040
Phone (206) 232-7546

15906 Mill Creek Blvd
Ste 105
Mill Creek, WA 98012
Phone 4253852009111

3825 Martin Way E
Ste 104
Olympia, WA 98506
Phone (971) 915-8579

19917 7th Ave NE
Ste 101
Poulsbo, WA 98370
Phone (360) 824-5474

19917 7th Ave NE
Ste 203
Poulsbo, WA 98370
Phone (360) 824-5474

3216 NE 45th Pl
Ste 203
Seattle, WA 98105
Phone (206) 525-1168

2415 NE 134th St
Ste 107
Vancouver, WA 98686
Phone (360) 576-3340

Interoperability endpoints

  • Direct secure messaging: klawlor@frontierdermpartners.emadirect.md

Organizations & group practices 1

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

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1215985833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 NE 45TH PLACE",
            "address_2": "STE 203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98105",
            "telephone_number": "206-525-1168",
            "fax_number": "206-525-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 NE 45TH PLACE",
            "address_2": "STE 203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98105",
            "telephone_number": "206-525-1168",
            "fax_number": "206-525-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWLOR",
        "first_name": "KEAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD30728",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WA",
            "license": "MD30728",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WA",
            "license": "MD30728",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WA",
            "license": "MD30728",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1109735",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.