Individual provider Active NPI

Myro A Lu, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Bethesda, MD
National Provider Identifier
1447413323
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
709 Issued in NE
Practice address
9080 Beale Rd
Bethesda, MD 20889-5633
Phone
(301) 400-2365
NPI assigned
Jul 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 709 NE Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

9080 Beale Rd
Bethesda, MD 20889-5633

Mailing address

Walter Reed National Military Medical Center
Bethesda, MD 20889-5600
Phone (301) 400-2365

Other practice location 1

1 Jarrett White Rd
Tripler Amc, HI 96859-5001
Phone (808) 433-3379

Other practice location 2

Madigan Army Medical Ctr
Department of Family Medicine
Tacoma, WA 98431-0001
Phone (253) 968-1340

Other practice location 3

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 798-3969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20200728002403 HI Order and Referring Only - Family PracticePractitioner - Family Practice 5799109468

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
709NEMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1447413323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WALTER REED NATIONAL MILITARY MEDICAL CENTER",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895600",
            "telephone_number": "301-400-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9080 BEALE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208895633",
            "telephone_number": "301-400-2365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Jarrett White Rd",
            "address_purpose": "LOCATION",
            "city": "Tripler Amc",
            "state": "HI",
            "postal_code": "968595001",
            "country_code": "US",
            "telephone_number": "808-433-3379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Madigan Army Medical Ctr",
            "address_2": "Department of Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984310001",
            "country_code": "US",
            "telephone_number": "253-968-1340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 Joel Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Campbell",
            "state": "KY",
            "postal_code": "422235318",
            "country_code": "US",
            "telephone_number": "270-798-3969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LU",
        "first_name": "MYRO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NE",
            "license": "709",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.