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KELLY LIESSE MD
NPI 1013458454
Pediatrics in Washington, DC

Active since March 18, 2017PECOS Enrolled
3522 10TH ST NW, WASHINGTON, DC 20010(630) 660-0161 Get Directions Write a Review

NPPES record last updated: August 13, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 13, 2023, Jun 8, 2021, Jun 25, 2020 and 1 more (4 updates tracked since 2017).

About Kelly Liesse Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY LIESSE MD (NPI 1013458454) is an individual pediatrics provider in Washington, District Of Columbia, licensed in District Of Columbia (MD210011400) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013458454
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameKELLY LIESSECredential: MD
Location Address3522 10TH ST NWWashington, DC 20010-1480
Mailing Address3522 10th St NwWashington, DC 20010-1480 · (630) 660-0161
Phone(630) 660-0161
Sole ProprietorYes
Enumeration DateMarch 18, 2017
Last NPPES UpdateAugust 13, 20234 updates tracked since enumeration
NPPES CertifiedAugust 13, 2023
✔ NPI 1013458454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in DC · MD210011400✔ Licensed in IL · 036.152067✔ Licensed in CA · A172837
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
3522 10TH ST NW, Washington, DC 20010
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Liesse Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Liesse reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc
2.7 mi
Health Maintenance Organization
700 2ND ST NE
Washington, DC 20002
NPI 1093016933 (202) 898-5100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20010 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$100.31 typical visit price
range $65.18 – $194.86
Typical copayment $25.07 (range $16.29 – $48.71)
Most-billed visit code 99203
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelly Liesse's NPI number?

The NPI number for Kelly Liesse is 1013458454. It was assigned to this individual provider in the NPPES registry on March 18, 2017.

Where is Kelly Liesse located?

Kelly Liesse practices at 3522 10th St NW, Washington, DC 20010. The listed phone number is (630) 660-0161.

What is Kelly Liesse's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kelly Liesse enrolled in Medicare?

Yes. Kelly Liesse is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Liesse's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Liesse reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc (Washington, DC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Liesse's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Liesse was last updated on August 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.