Individual provider Active NPI

Lionel Mue Kum, PA-C

  • Medical Physician Assistant
  • Princess Anne, MD
National Provider Identifier
1942669494
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
12208 Brittingham Rd
Princess Anne, MD 21853-2214
Phone
(410) 651-1410
NPI assigned
Feb 12, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

12208 Brittingham Rd
Princess Anne, MD 21853-2214

Mailing address

205 Center St Ste 206
Mount Airy, MD 21771-5499
Phone (443) 421-1291

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: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160421000431 MD Practitioner - Physician Assistant 8729386974 Reassigns benefits to 3 organizations
I20180206000749 DC Practitioner - Physician Assistant 8729386974 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

1311 Londontown Blvd
Suite 130
Eldersburg, MD 21784-6556
Phone (410) 549-7222

1505 E Churchville Rd
Bel Air, MD 21014-4742

4900 Beaver Run CT
Ellicott City, MD 21043-7917
Phone (443) 542-9630

504 E Ridgeville Blvd
A
Mount Airy, MD 21771-5942
Phone (301) 703-5452

9122 Hinks LN
Frederick, MD 21704-7005
Phone (240) 341-2654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries, LLC CurrentSince Jan 1, 2022 Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 1, 2020 Accepting new patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Jan 1, 2022 Accepting new patients
MNR Industries, LLC CurrentSince Jan 1, 2022 Accepting new patients
Mep Health, LLC CurrentSince Jan 1, 2026 Accepting new patients
Medstar Urgent Care LLC CurrentSince Dec 1, 2020 Accepting new patients
Ell.E Wellness Medical Current Accepting new patients

Locations

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

7698 Dorchester Blvd
Ste 204
Hanover, MD 21076

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

12220 Rockville Pike
Rockville, MD 20852
Phone (301) 468-6483

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

3350 Crain Hwy
Waldorf, MD 20603
Phone (443) 332-4260

1011 Baltimore Blvd
Westminster, MD 21157
Phone (410) 848-1329

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1942669494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 CENTER ST STE 206",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715499",
            "telephone_number": "443-421-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12208 BRITTINGHAM RD",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218532214",
            "telephone_number": "410-651-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUM",
        "first_name": "LIONEL",
        "middle_name": "MUE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-12",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princess Anne, MD

Sources for this page

Verify at the official NPI Registry.