Charles J Lilly, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

4301048544 Issued in MI

Practice address

2890 Health Parkway
Mount Pleasant, MI 48858

Phone

(989) 772-3886

Fax

(989) 773-6267

NPI assigned

Sep 26, 2006

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.lilly@1152.chartlogic.direct-ci.com

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

• Charles J Lilly MD PC

  • Orthopaedic Surgery Physician
  • Mt Pleasant, MI
  • NPI 1619167996
  Medicare reassignment NPD Authorized official
• McLaren Central Michigan

  • Rural Health Clinic/Center
  • Gladwin, MI
  • NPI 1841812989
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222732800000",
    "number": "1043311848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 CEDAR DR",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488589027",
            "telephone_number": "989-772-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 HEALTH PARKWAY",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-772-3886",
            "fax_number": "989-773-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301048544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1644906",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "00370822",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jody Robin Lewis, LLP
• Lixuan Li, PA
• Joseph Michael Liberati, PT, DPT
• Steven Adam Lifson, PHD
• Gabrielle Likavec
• Ryan Joseph Lilly, M.D.
• Stacey Rochelle Lim, AU.D.
• Jennifer Lynn Lindow, PTA,PM
• Jason Lindsey
• Elizabeth D Ling

• Orthopaedic Surgery Physician in Mt Pleasant, MI
• Providers in Mt Pleasant, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.