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Individual provider Active NPI

Joseph Vincent Lillis, M.D.

  • Dermatology Physician
  • Fort Collins, CO
National Provider Identifier
1225213432
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
DR.0047867 Issued in CO
Practice address
3609 S Timberline Rd Unit a
Fort Collins, CO 80525-3430
Phone
(970) 305-4341
Fax
(970) 482-9948
NPI assigned
Jan 7, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X LL16967 OR
Dermatology Physician 207N00000X A109366 CA
Procedural Dermatology Physician 207NS0135X 47867 CO
Dermatology Physician 207N00000X DR.0047867 CO Primary

Addresses

Primary practice location

3609 S Timberline Rd Unit a
Fort Collins, CO 80525-3430

Mailing address

2121 E. Harmony Rd
Suite 270
Fort Collins, CO 80528-3402
Phone (970) 305-4341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140904000899 CO Practitioner - Dermatology 6901943927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Georgetown University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Dermatology Group PLLCGroup PAC ID 5294022737, 4 clinicians

Practice addresses (Care Compare)

3609 S Timberline Rd
Unit a
Fort Collins, CO 80525-3430
Phone (970) 305-4341

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision196
Removal of skin lesions1766
Removal of skin cancer593
Removal or shaving of skin growth98
Skin biopsy781

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL16967ORMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
R Jeffrey Herten MD Inc Dermatology PastSince Sep 1, 2010 Accepting new patients

Organizations & group practices 2

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1225213432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E. HARMONY RD",
            "address_2": "SUITE 270",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805283402",
            "telephone_number": "970-305-4341",
            "fax_number": "970-482-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 S TIMBERLINE RD UNIT A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805253430",
            "telephone_number": "970-305-4341",
            "fax_number": "970-482-9948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLIS",
        "first_name": "JOSEPH",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-07",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OR",
            "license": "LL16967",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A109366",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CO",
            "license": "47867",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "DR.0047867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.