Active NPI
Lilly Phan
- Optometrist
- Hadley, MA
National Provider Identifier
1003619966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 11370TG
- Practice address
- 6 Isabel CT
Hadley, MA 01035-3529 - Phone
- (774) 448-9237
- NPI assigned
- Mar 28, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 11370TG | TX | Primary |
Addresses
Primary practice location
6 Isabel CT
Hadley, MA 01035-3529
Mailing address
2002 Holcombe Blvd
Houston, TX 77030-4211
Phone (774) 448-9237
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11370TG | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755388800000",
"number": "1003619966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 HOLCOMBE BLVD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770304211",
"telephone_number": "774-448-9237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 ISABEL CT",
"city": "HADLEY",
"state": "MA",
"postal_code": "010353529",
"telephone_number": "774-448-9237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "LILLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-28",
"last_updated": "2025-08-17",
"certification_date": "2025-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "11370TG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hadley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.