Individual provider Active NPI

Kailin Lieu

  • Pediatrics Physician
  • Bethesda, MD
National Provider Identifier
1952765190
Registry record updated Mar 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD466879 Issued in PA
Practice address
7700 Old Georgetown Rd FL 4
Bethesda, MD 20814-6224
Phone
(240) 482-3200
NPI assigned
Apr 13, 2016
Last updated
Mar 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X MD466879 PA Primary
Pediatric Hematology & Oncology Physician 2080P0207X MD466879 PA

Addresses

Primary practice location

7700 Old Georgetown Rd FL 4
Bethesda, MD 20814-6224

Mailing address

7700 Old Georgetown Rd FL 4
Bethesda, MD 20814-6224
Phone (240) 482-3200

Other practice location 1

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (215) 590-1000

Other practice location 2

111 Michigan Ave NW
Washington, DC 20010-2916
Phone (202) 476-3670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD466879PAMDPediatric Hematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709337600000",
    "number": "1952765190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 OLD GEORGETOWN RD FL 4",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208146224",
            "telephone_number": "240-482-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 OLD GEORGETOWN RD FL 4",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208146224",
            "telephone_number": "240-482-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "215-590-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Michigan Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200102916",
            "country_code": "US",
            "telephone_number": "202-476-3670",
            "fax_number": "202-476-4741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEU",
        "first_name": "KAILIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2024-03-02",
        "certification_date": "2024-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD466879",
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "PA",
            "license": "MD466879",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.