Individual provider Active NPI

Lillibet Mathew Placheril, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Bradenton, FL
National Provider Identifier
1235174079
Registry record updated Mar 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
ME63167 Issued in FL
Practice address
1906 59TH St W Ste B
Bradenton, FL 34209-4639
Phone
(941) 795-1915
Fax
(866) 305-3603
NPI assigned
Jun 17, 2006
Last updated
Mar 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X ME63167 FL Primary

Addresses

Primary practice location

1906 59TH St W Ste B
Bradenton, FL 34209-4639

Mailing address

1906 59TH St W Ste B
Bradenton, FL 34209-4639
Phone (941) 795-1915

Other names 1

  • Lillibet Mathew Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20070124000042 FL Practitioner - EndocrinologyPractitioner - Internal Medicine 6608877303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1906 59TH St W
Suite B
Bradenton, FL 34209-4639
Phone (941) 795-1915

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME63167FLMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bradenton Endocrinology, PA CurrentSince Jun 1, 1997 Accepting new patients

Locations

1906 59th St W
Ste B
Bradenton, FL 34209
Phone (941) 795-1915

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGFCAD
  • FHIR API: https://fhir4.healow.com/fhir/r4/DGFCAD/Endpoint/DGFCAD

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616198400000",
    "number": "1235174079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 59TH ST W STE B",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094639",
            "telephone_number": "941-795-1915",
            "fax_number": "866-305-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 59TH ST W STE B",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094639",
            "telephone_number": "941-795-1915",
            "fax_number": "866-305-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLACHERIL",
        "first_name": "LILLIBET",
        "middle_name": "MATHEW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-03-20",
        "certification_date": "2021-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "FL",
            "license": "ME63167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILLIBET",
            "last_name": "MATHEW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.