Individual provider Active NPI

Thomas T. Le, M.D.

  • Facial Plastic Surgery Physician
  • Ellicott City, MD
National Provider Identifier
1245245802
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
D61873 Issued in MD
Practice address
4785 Dorsey Hall Dr Ste 111
Ellicott City, MD 21042-7862
Phone
(877) 917-3223
Fax
(443) 219-0758
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X D61873 MD
Facial Plastic Surgery Physician 207YS0123X D61873 MD Primary

Addresses

Primary practice location

4785 Dorsey Hall Dr Ste 111
Ellicott City, MD 21042-7862

Mailing address

4785 Dorsey Hall Dr Ste 111
Ellicott City, MD 21042-7862
Phone (877) 917-3223

Other practice location 1

22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 328-6897

Other identifiers 8

IdentifierTypeStateIssuer
252644OtherMDKAISER
3125711OtherMDMDIPA
64272901OtherMDBLUE SHIELD
0006OtherMDCAREFIRST REGIONAL
1001582OtherMDUNITED HLTHCARE
2313163OtherMDUNITED HLTHCARE NATIONAL
406120900MedicaidMD
94501OtherMDGEISINGER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D61873MDMDFacial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Baltimore-Washington Facial Plastic Surgery, LLC Facial Plastic Surgery PastSince Apr 27, 2025 Accepting new patients

Organizations & group practices 2

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": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1245245802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4785 DORSEY HALL DR STE 111",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427862",
            "telephone_number": "877-917-3223",
            "fax_number": "443-219-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4785 DORSEY HALL DR STE 111",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427862",
            "telephone_number": "877-917-3223",
            "fax_number": "443-219-0758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-6897",
            "fax_number": "410-328-2109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "THOMAS",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D61873",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MD",
            "license": "D61873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "252644",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDIPA",
            "identifier": "3125711",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "64272901",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST REGIONAL",
            "identifier": "0006",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HLTHCARE",
            "identifier": "1001582",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HLTHCARE NATIONAL",
            "identifier": "2313163",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406120900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEISINGER",
            "identifier": "94501",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.