Individual provider Active NPI

Lysa Charles, MD

  • Orthopaedic Surgery Physician
  • Rockville, MD
National Provider Identifier
1497832083
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
D0053807 Issued in MD
Practice address
2101 E Jefferson St Ppqa Medicare Compliance Unt 6 West
Kaiser Permanente Mid Atlantic Permanente Medical Group
Rockville, MD 20852-4908
Phone
(301) 816-6660
Fax
(301) 816-6308
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X D0053807 MD Primary

Addresses

Primary practice location

2101 E Jefferson St Ppqa Medicare Compliance Unt 6 West
Kaiser Permanente Mid Atlantic Permanente Medical Group
Rockville, MD 20852-4908

Mailing address

2101 E Jefferson St Ppqa Medicare Compliance Unt 6 West
Kaiser Permanente Mid Atlantic Permanente Medical Group
Rockville, MD 20852-4908
Phone (301) 816-6660

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041122000515 MD Practitioner - Orthopedic Surgery 1355306101 Reassigns benefits to 3 organizations
I20210324001178 DC Practitioner - Orthopedic Surgery 1355306101 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, shared by 17 NPIs, 1,921 clinicians

Practice addresses (Care Compare)

1701 Twin Springs Rd
Halethorpe, MD 21227-3553
Phone (410) 737-5000

7070 Samuel Morse Dr
Columbia, MD 21046-3424
Phone (410) 309-4600

888 Bestgate Rd
Annapolis, MD 21401-3091
Phone (410) 571-7300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0053807MDMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Orthopaedic Surgery Current Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Apr 23, 2009 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Dec 1, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Jan 1, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 1, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Apr 23, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Chesapeake Orthopaedic and Sports Medicine Center PA Orthopaedic Surgery Past Accepting new patients

Locations

7070 Samuel Morse Dr
Columbia, MD 21046
Phone (410) 309-4600

7190 Crestwood Blvd
Frederick, MD 21703
Phone (240) 529-1700

1701 Twin Springs Rd
Halethorpe, MD 21227
Phone (410) 737-5000

10810 Connecticut Ave
Kensington, MD 20895
Phone (301) 929-7100

1221 Mercantile Ln
Fl 3
Largo, MD 20774
Phone (301) 618-5500

655 Watkins Mill Rd
Montgomery Village, MD 20879
Phone (301) 929-7100

2101 E Jefferson St
#6W
Rockville, MD 20852
Phone (301) 816-6660

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

2101 E Jefferson St
#4E
Rockville, MD 20852

2101 E Jefferson St
Ste 6
Rockville, MD 20852

2101 E Jefferson St
Ste 4EPFS
Rockville, MD 20852

2391 Greenspring Dr
Timonium, MD 21093
Phone (410) 847-3000

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400

Interoperability endpoints

  • Direct secure messaging: lcharles551087@direct.umm.edu

Organizations & group practices 12

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1497832083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST",
            "address_2": "KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-6660",
            "fax_number": "301-816-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST",
            "address_2": "KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524908",
            "telephone_number": "301-816-6660",
            "fax_number": "301-816-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "LYSA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MD",
            "license": "D0053807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1701 Twin Springs Rd",
            "city": "Halethorpe",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212273553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.