Nicholas Vijay Lillie, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004659 Issued in MI

Practice address

6101 Lake Michigan Dr
Suite B 700
Allendale, MI 49401-9215

Phone

(616) 895-2020

Fax

(616) 895-2060

NPI assigned

Jul 18, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allendale Family Vision LLCGroup PAC ID 0941478499, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Allendale Family Vision LLC

  • Optometrist
  • Allendale, MI
  • NPI 1639467962
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1053609693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 LAKE MICHIGAN DR",
            "address_2": "STE B700",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019215",
            "telephone_number": "616-895-2020",
            "fax_number": "616-895-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 LAKE MICHIGAN DR",
            "address_2": "SUITE B 700",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494019215",
            "telephone_number": "616-895-2020",
            "fax_number": "616-895-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLIE",
        "first_name": "NICHOLAS",
        "middle_name": "VIJAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-18",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Jane Lane
• Shaina Marie Lane, M.ED., ATC
• Beth Ledy
• Warren N Leemgraven, BS, CAC I
• John A Lemke, DO
• Alyvia Long
• Lydia Lorenz
• Austin Loshinskie, OD
• Ryan Michael Loupee, DC
• Emma Luedtke

• Optometrist in Allendale, MI
• Providers in Allendale, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.