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DR. LILLIAN KIM IVANSCO M.D. M.P.H. NPI 1043478605


NPI Information

NPI: 1043478605
Provider Name: DR. LILLIAN KIM IVANSCO, M.D., M.P.H.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
20 GLENLAKE PKWY
ATLANTA, GA
ZIP 30328
Phone: (404) 364-7285
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DR. Lillian Kim Ivansco, M.D., M.P.H. is a diagnostic radiology radiology in Atlanta, GA with 16 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Lillian Kim Ivansco, M.D., M.P.H. NPI is 1043478605. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2008

The provider's business location address is:

20 GLENLAKE PKWY
ATLANTA, GA
ZIP 30328-473
Phone: (404) 364-7285

The NPI 1043478605 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Mammography of both breasts (HCPCS:77067)

The enumeration date for this NPI number is 5/29/2008 and was last updated on 1/10/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic Radiology069869GEORGIAYes
22085R0202XRadiologyDiagnostic RadiologyMD17668HAWAIINo
32085R0202XRadiologyDiagnostic Radiology04-37114KANSASNo
42085R0202XRadiologyDiagnostic Radiology27713NEBRASKANo
52085R0202XRadiologyDiagnostic Radiology53370COLORADONo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
110026277300MEDICAIDNEBRASKA
2201098570AMEDICAIDKANSAS
366229006MEDICAIDNEW MEXICO
410026277500MEDICAIDNEBRASKA
510026277700MEDICAIDNEBRASKA
610026277800MEDICAIDNEBRASKA
779754571MEDICAIDCOLORADO
810026277600MEDICAIDNEBRASKA
9929695MEDICAIDARIZONA
101043478605MEDICAIDMONTANA
1110026277400MEDICAIDNEBRASKA
121043478605MEDICAIDIOWA
1310025709000MEDICAIDNEBRASKA
141043478605MEDICAIDWYOMING
151043478605MEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.