Individual provider Active NPI

Kathryn Dee Lizcano Macmillan, M.D.

  • Pediatrics Physician
  • Lebanon, NH
National Provider Identifier
1861836629
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
17776 Issued in NH
Practice address
1 Medical Center Dr
DHMC Department of Pediatrics
Lebanon, NH 03756-1000
Phone
(603) 650-6108
Fax
(603) 640-1228
NPI assigned
Apr 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 17776 NH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1 Medical Center Dr
DHMC Department of Pediatrics
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
DHMC Department of Pediatrics
Lebanon, NH 03756-1000
Phone (603) 650-6108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 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
I20181002003765 MA Practitioner - Pediatric Medicine 1153620380 Reassigns benefits to 3 organizations
I20251205000374 NH Practitioner - Pediatric Medicine 1153620380 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Geisel School of Medicine at Dartmouth, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Suite 810
Hanover, NH 03755

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Sep 27, 2018 Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Sep 7, 2021 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Nov 1, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital Pediatrics CurrentSince Nov 1, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Nov 1, 2025 Accepting new patients
Massachusetts General Physicians Organization Inc Pediatrics CurrentSince Sep 27, 2018 Accepting new patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic Pediatrics CurrentSince Nov 1, 2025 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

75 Francis St
Boston, MA 02115

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

Interoperability endpoints

  • Direct secure messaging: kmacmillan115815@direct.dartmouth-hitchcock.org

Organizations & group practices 8

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": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1861836629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC DEPARTMENT OF PEDIATRICS",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC DEPARTMENT OF PEDIATRICS",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-6108",
            "fax_number": "603-640-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACMILLAN",
        "first_name": "KATHRYN DEE",
        "middle_name": "LIZCANO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "17776",
            "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 Lebanon, NH

Sources for this page

Verify at the official NPI Registry.