BRUCE S LIESE (PHD) – Psychologist, NPI 1770676223

BRUCE S LIESE (PHD) is a healthcare provider. based in Kansas city, Missouri. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 0616 (KS). The NPI Number for BRUCE S LIESE (PHD) is 1770676223

Main info

Male
43 Years Of Experience
Accepts Medicare Assignment
Name
BRUCE S LIESE (PHD)
NPI
1770676223
Phone
(913) 588-1944
Address
PO BOX 411851
Enumeration Date
2 October 2006
Last Update Date
16 July 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9135881227
Graduation Year
1983 (43 years ago)
PAC ID
4688790140
Group Practice PAC ID
8921911587
Professional Enrollment ID
I20101014000035
Address ID
KS661608501KA4000XSTXX320
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

282 CLINICAL PSYCHOLOGIST in KS

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Provider Addresses for BRUCE S LIESE (PHD)

  • Jack in the Box, South 18th Street, Kansas City, Wyandotte County, Kansas, 66102, United States

    KANSAS CITY, MO 641411851

    Phone: (913) 588-1944

    Fax: (913) 588-2496

    Type: Mailing

  • University of Kansas Medical Center, 3901, Rainbow Boulevard, Kansas City, Wyandotte County, Kansas, 66160, United States

    MS 4017

    KANSAS CITY, KS 661600001

    Phone: (913) 588-1944

    Fax: (913) 588-2496

    Type: Location

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: 2010-10-14

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
I20101014000035IClinical PsychologistKSTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64141)

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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: 8921911587View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm BRUCE S LIESE (PHD)'s NPI?
Yes. BRUCE S LIESE (PHD) is listed with NPI 1770676223 in the public NPI dataset.
Does CMS list BRUCE S LIESE (PHD) as active?
Yes — BRUCE S LIESE (PHD) is active in the NPI listing used on this page.
What healthcare role does BRUCE S LIESE (PHD) hold?
Scheduling teams often label BRUCE S LIESE (PHD) under Psychologist. Clinical services aligned with this taxonomy classification.
Where is BRUCE S LIESE (PHD) based?
BRUCE S LIESE (PHD) is tied to Kansas City, Missouri in the data we show; additional addresses may exist on the full record.
Why does BRUCE S LIESE (PHD) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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