MS. LORI B INDENBAUM (PA-C) – Physician Assistant, NPI 1255340683

MS. LORI B INDENBAUM (PA-C) is a healthcare provider. based in Rockville, Maryland. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. C01810 (MD). The NPI Number for MS. LORI B INDENBAUM (PA-C) is 1255340683

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
MS. LORI B INDENBAUM (PA-C)
NPI
1255340683
Phone
(301) 816-2414
Address
2101 E JEFFERSON ST
Enumeration Date
5 August 2006
Last Update Date
2 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3013842166
Graduation Year
1996 (30 years ago)
PAC ID
5890972194
Group Practice PAC ID
3971730946
Professional Enrollment ID
I20110614000855
Address ID
MD209055631SI15200AVEX401
Telehealth
Yes

Contacts

SOAP Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

3,366 PHYSICIAN ASSISTANT in MD

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Provider Addresses for MS. LORI B INDENBAUM (PA-C)

  • East Jefferson Street, Croydon Park, Rockville, Montgomery County, Maryland, 20850-3827, United States

    ROCKVILLE, MD 208524908

    Phone: (301) 816-2414

    Fax: (301) 388-1740

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-06-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110614000855IPhysician AssistantDCTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes2515$0
View full utilization report →

Insurance plans in this area (ZIP 20852)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3971730946View full group profile
NameSpecialtyState
O P H T H A L M O L O G YMD
Nurse PractitionerNY
Nurse PractitionerMD
Nurse PractitionerMD
Nurse PractitionerMD
Nurse PractitionerMD
Cardiovascular Disease (Cardiology)MD
Internal Medicine, Peripheral Vascular DiseaseFL

Reviews

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Frequently asked questions

Does MS. LORI B INDENBAUM (PA-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MS. LORI B INDENBAUM (PA-C) uses 1255340683.
Is MS. LORI B INDENBAUM (PA-C) listed as active for patients and plans?
The listing shows MS. LORI B INDENBAUM (PA-C) as active in the NPI system.
What healthcare role does MS. LORI B INDENBAUM (PA-C) hold?
Scheduling teams often label MS. LORI B INDENBAUM (PA-C) under Physician Assistant. Clinical services aligned with this taxonomy classification.
What area does MS. LORI B INDENBAUM (PA-C) serve?
MS. LORI B INDENBAUM (PA-C)'s listing highlights Rockville, Maryland; more addresses can appear in NPPES.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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