Individual provider Active NPI

Lois G Lello, MD

  • Pediatrics Physician
  • Niles, MI
National Provider Identifier
1255367850
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301067372 Issued in MI
Practice address
2002 S 11TH St
Niles, MI 49120-4074
Phone
(269) 687-0200
Fax
(269) 684-0199
NPI assigned
Jun 24, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301067372 MI Primary

Addresses

Primary practice location

2002 S 11TH St
Niles, MI 49120-4074

Mailing address

2002 S 11TH St
Niles, MI 49120-4074
Phone (269) 687-0200

Other identifiers 1

IdentifierTypeStateIssuer
3501101662OtherMIBLUE CROSS PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050721000919 MI Practitioner - Pediatric Medicine 7911934880 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301067372MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Community Hospital Watervliet Current Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Oct 6, 2013 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Oct 6, 2013 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Apr 2, 2014 Accepting new patients
Lakeland Community Hospital Watervliet Past Accepting new patients

Locations

2002 S 11th St
Niles, MI 49120
Phone (269) 687-0200

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

Interoperability endpoints

  • FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
  • Direct secure messaging: lburn1270513@epic00.corewelldirect.org
  • Direct secure messaging: llellomd1435@lakeland.midirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1255367850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 S 11TH ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204074",
            "telephone_number": "269-687-0200",
            "fax_number": "269-684-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 S 11TH ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204074",
            "telephone_number": "269-687-0200",
            "fax_number": "269-684-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LELLO",
        "first_name": "LOIS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301067372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "3501101662",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

Verify at the official NPI Registry.