Individual provider Active NPI

Regina Zvitkovitz Lilly, MD

  • Internal Medicine Physician
  • Penn Yan, NY
National Provider Identifier
1013006154
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
219816 Issued in NY
Practice address
418 N Main St
Penn Yan, NY 14527-1070
Phone
(315) 787-4000
Fax
(315) 536-0430
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 219816 NY Primary

Addresses

Primary practice location

418 N Main St
Penn Yan, NY 14527-1070

Mailing address

418 N Main St
Penn Yan, NY 14527-1070
Phone (315) 787-4000

Other identifiers 6

IdentifierTypeStateIssuer
2108056MedicaidNY
2589769OtherNYGHI
P010219816OtherNYBLUE CHOICE
219816-6OtherNYWORKER'S COMP
P010219816OtherNYBLUE SHIELD
16832BJOtherNYPREFERRED CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Heights Nephrology Medical Group, PC Past Accepting new patients
FLH Medical, PC Past Accepting new patients
FLH Medical, PC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1013006154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 N MAIN ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271070",
            "telephone_number": "315-787-4000",
            "fax_number": "315-536-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 N MAIN ST",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145271070",
            "telephone_number": "315-787-4000",
            "fax_number": "315-536-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "REGINA",
        "middle_name": "ZVITKOVITZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "219816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2108056",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2589769",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010219816",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMP",
            "identifier": "219816-6",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "P010219816",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "16832BJ",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Penn Yan, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.