Mary Susan Lilly, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 3537 Issued in FL

Practice address

3875 US Highway 301 S
Riverview, FL 33578

Phone

(813) 246-3186

Fax

(813) 542-2246

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sight and Sun Eyeworks LLCGroup PAC ID 0042362527, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: marylilly@direct.eyecare-partners.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sight and Sun Eyeworks LLC

  • Optometrist
  • Pensacola, FL
  • NPI 1932359106
  Medicare reassignment Care Compare group NPD
• Fishhawk Family Eyecare

  • Optometrist
  • Lithia, FL
  • NPI 1952640104
  NPD (past) Authorized official
• Sight and Sun Eyeworks LLC

  • Optometrist
  • Lakeland, FL
  • NPI 1437817467
  NPD
• Dr. Chris Russell, PA

  • Optometrist
  • Valrico, FL
  • NPI 1073816906
  NPD (past)
• Sight and Sun Eyeworks LLC

  • Optometrist
  • Gulf Breeze, FL
  • NPI 1932386620
  NPD (past)
• Nationwide Optometry P.C.

  • Optometrist
  • Tempe, AZ
  • NPI 1326472945
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1003907650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 GOLF MANOR BLVD",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335967852",
            "telephone_number": "813-716-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 US HIGHWAY 301 S",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "33578",
            "telephone_number": "813-246-3186",
            "fax_number": "813-542-2246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5458 Lithia Pinecrest Rd",
            "address_purpose": "LOCATION",
            "city": "Lithia",
            "state": "FL",
            "postal_code": "335472853",
            "country_code": "US",
            "telephone_number": "813-689-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLY",
        "first_name": "MARY",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6205704 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Jo Lienhart, DO
• Life Balance and Beauty
• Lifeway Programs Inc
• Lightning Therapy LLC
• Lil Sprouts Pediatric Therapy Services LLC
• Lillybash Dental Studio PLLC
• Limitless Therapy, LLC.
• Natalie Lincoln, CRNA
• Lisa a Amato OD PA
• Lithia Assisted Living LLC

• Optometrist in Riverview, FL
• Providers in Riverview, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.