Individual provider Active NPI

Melissa R Lill, CRNP

  • Women's Health Nurse Practitioner
  • Sacaton, AZ
National Provider Identifier
1124323621
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP4366 Issued in AZ
Practice address
483 W. Seed Farm Rd
Sacaton, AZ 85147
Phone
(602) 528-1200
Fax
(602) 528-1255
NPI assigned
Jan 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP4366 AZ Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X SP011112 PA

Addresses

Primary practice location

483 W. Seed Farm Rd
Sacaton, AZ 85147

Mailing address

PO Box 38
Sacaton, AZ 85147-0001
Phone (602) 528-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150526000365 TX Practitioner - Nurse Practitioner 3971823477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

291 W Casa Blanca Rd
Hu Hu Kam Memorial Hospital
Sacaton, AZ 85147-0038
Phone (520) 562-3323

483 W Seed Farm Rd
Sacaton, AZ 85147-0038

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
76.88
Promoting interoperability
76
Improvement activities
40
Cost
73.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP011112PAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care Corporation CurrentSince May 6, 2015 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Gila River Health Care CurrentSince May 6, 2015 Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1294963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1124323621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851470001",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "483 W. SEED FARM RD",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "85147",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILL",
        "first_name": "MELISSA",
        "middle_name": "R",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-14",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "AP4366",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "PA",
            "license": "SP011112",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacaton, AZ

Sources for this page

Verify at the official NPI Registry.