Active NPI
Emma Lauren Lietz
- Physician Assistant
- Largo, MD
National Provider Identifier
1942948120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110008741
- Practice address
- 1221 Mercantile LN
Largo, MD 20774-5374 - Phone
- (301) 618-5500
- NPI assigned
- May 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 0110008741 | VA | Primary |
Addresses
Primary practice location
1221 Mercantile LN
Largo, MD 20774-5374
Mailing address
1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-7184
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30017491380002 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.54 of 100
- Quality
- 84.62
- Improvement activities
- 40
- Cost
- 76.68
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110008741 | VA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients |
Locations
1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500
Organizations & group practices 7
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.
-
- Health Maintenance Organization
- Annapolis, MD
- NPI 1952461816
DC
-
- Radiology Clinic/Center
- Ashburn, VA
- NPI 1568615094
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Rockville, MD
- NPI 1962108753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778025600000",
"number": "1942948120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1221 MERCANTILE LN",
"city": "LARGO",
"state": "MD",
"postal_code": "207745374",
"telephone_number": "301-618-7184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 MERCANTILE LN",
"city": "LARGO",
"state": "MD",
"postal_code": "207745374",
"telephone_number": "301-618-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIETZ",
"first_name": "EMMA",
"middle_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-26",
"last_updated": "2026-05-06",
"certification_date": "2026-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110008741",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30017491380002",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Largo, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.