Individual provider Active NPI

Andrew Lane Liss, DPM

  • Podiatrist
  • Kensington, MD
National Provider Identifier
1861587313
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
4326 Issued in MD
Practice address
10901 Connecticut Ave
Suite 200
Kensington, MD 20895-1645
Phone
(301) 949-2000
Fax
(301) 949-2002
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 4326 MD Primary

Addresses

Primary practice location

10901 Connecticut Ave
Suite 200
Kensington, MD 20895-1645

Mailing address

1600 E Gude Dr
Suite 200
Rockville, MD 20850-1341
Phone (301) 933-7133

Other identifiers 1

IdentifierTypeStateIssuer
602278200MedicaidMD

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110316000115 MD Practitioner - Podiatry 7012199805 Reassigns benefits to 1 organization
I20110316000225 DC Practitioner - Podiatry 7012199805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.95 of 100Reported as group
Promoting interoperability
87
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
436MDMDMental Health Counselor
4326MDMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Jan 1, 2014 Accepting new patients
Foot and Ankle Specialists of the Mid-Atlantic, LLC Podiatrist CurrentSince Jan 1, 2014 Accepting new patients

Locations

6100 Daylong Ln
Ste 208
Clarksville, MD 21029
Phone (443) 535-8770

11055 Little Patuxent Pkwy
Ste 204
Columbia, MD 21044
Phone (410) 720-0003

10901 Connecticut Ave
Ste 200
Kensington, MD 20895
Phone (301) 949-2000

8028 Ritchie Hwy
Ste 100
Pasadena, MD 21122
Phone (410) 356-9939

11801 Rockville Pike
Ste 105
Rockville, MD 20852
Phone (301) 770-5741

1600 E Gude Dr
Ste 200
Rockville, MD 20850

2415 Musgrove Rd
Ste 103
Silver Spring, MD 20904
Phone (301) 384-6500

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1861587313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E GUDE DR",
            "address_2": "SUITE 200",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501341",
            "telephone_number": "301-933-7133",
            "fax_number": "301-933-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10901 CONNECTICUT AVE",
            "address_2": "SUITE 200",
            "city": "KENSINGTON",
            "state": "MD",
            "postal_code": "208951645",
            "telephone_number": "301-949-2000",
            "fax_number": "301-949-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISS",
        "first_name": "ANDREW",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "4326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "602278200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kensington, MD

Sources for this page

Verify at the official NPI Registry.