Individual provider Active NPI

Lillian Rojo Blue, MD

  • Pediatrics Physician
  • Wichita, KS
National Provider Identifier
1508907429
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
04-32441 Issued in KS
Practice address
550 N Hillside St BLDG 16TH
Ku Wichita Pediatrics
Wichita, KS 67214-4910
Phone
(316) 962-7422
Fax
(316) 962-7805
NPI assigned
Feb 12, 2007
Last updated
Jan 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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 04-32441 KS Primary

Addresses

Primary practice location

550 N Hillside St BLDG 16TH
Ku Wichita Pediatrics
Wichita, KS 67214-4910

Mailing address

550 N Hillside St BLDG 16TH
Ku Wichita Pediatrics
Wichita, KS 67214-4910
Phone (316) 962-7422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20070822000233 KS Practitioner - Pediatric Medicine 0042302481 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kansas School of Medicine Wichita Medical Practice Assoc Pediatrics CurrentSince Mar 15, 2018 Accepting new patients
Wesley Pathology Consultants PA Current Accepting new patients
Wesley Medical Center LLC Past Accepting new patients

Locations

1010 N Kansas St
Wichita, KS 67214
Phone (316) 293-2622

1010 N Kansas St
Ste 3054
Wichita, KS 67214
Phone (316) 293-2647

3243 E Murdock St
Ste Lvl-A
Wichita, KS 67208
Phone (316) 688-3150

3243 E Murdock St
Ste Lvl-G
Wichita, KS 67208
Phone (316) 962-3100

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

550 N Hillside St
Bldg 16TH
Wichita, KS 67214
Phone (316) 962-7422

Organizations & group practices 3

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1508907429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 N HILLSIDE ST BLDG 16TH",
            "address_2": "KU WICHITA PEDIATRICS",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144910",
            "telephone_number": "316-962-7422",
            "fax_number": "316-962-7805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N HILLSIDE ST BLDG 16TH",
            "address_2": "KU WICHITA PEDIATRICS",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144910",
            "telephone_number": "316-962-7422",
            "fax_number": "316-962-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "LILLIAN",
        "middle_name": "ROJO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "04-32441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.