Stephanie Lilly, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

SP019836 Issued in PA

Practice address

3901 Bear Creek Blvd
Bear Creek Township, PA 18702-9752

Phone

(570) 574-4611

NPI assigned

Oct 25, 2018

Last updated

Mar 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Stephanie Gleco Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nepa Vascular Institute LLCGroup PAC ID 2769852383, 3 clinicians

Nepa Vascular LLCGroup PAC ID 3779921358, 3 clinicians

Physiatry Consultants of NC PLLCGroup PAC ID 2567871643, 77 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26945/brand/1/csg/1/fhir/r4
• Direct secure messaging: stephanie.lilly.1@26945.direct.athenahealth.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.

• Nepa Vascular Institute LLC

  dba NEPA Wound Care

  • Clinic/Center
  • Berwick, PA
  • NPI 1366179343
  Medicare reassignment Care Compare group NPD
• Nepa Vascular LLC

  • Vascular Surgery Physician
  • Berwick, PA
  • NPI 1679338685
  Medicare reassignment Care Compare group NPD
• Physiatry Consultants of NC PLLC

  • Physical Medicine & Rehabilitation Physician
  • Morton Grove, IL
  • NPI 1437736881

  PA

  Medicare reassignment Care Compare group
• Medical Center of Northeastern PA LLC

  • Internal Medicine Physician
  • Kingston, PA
  • NPI 1063715639
  Medicare reassignment NPD
• Schuylkill Health System Medical Group, Inc.

  dba Lehigh Valley Physician Group-Schuylkill

  • Internal Medicine Physician
  • Pottsville, PA
  • NPI 1588603567
  Medicare reassignment NPD
• Scot R. McKenna, M.D., P.C.

  • Plastic Surgery Physician
  • South Abington Township, PA
  • NPI 1154409472
  Medicare reassignment NPD
• Restore Abundant Health LLC

  • Nurse Practitioner
  • Bear Creek Township, PA
  • NPI 1609718220
  NPD Authorized official
• Lehigh Valley Physician Group

  dba LVPG Family and Internal Medicine - East Stroudsburg

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650
  NPD
• Lehigh Valley Physician Group

  dba LVPG Occupational Medicine

  • Occupational Medicine Clinic/Center
  • Pittston, PA
  • NPI 1528708781
  NPD
• Schuylkill Health System Medical Group, Inc.

  dba LVPG ExpressCare Schuylkill

  • Emergency Medicine Physician
  • Pottsville, PA
  • NPI 1063073823
  NPD
• Pam Squared at Dover LLC

  dba PAM Rehabilitation Hospital of Dover

  • Rehabilitation Hospital
  • Dover, DE
  • NPI 1295221372
  NPD (past)

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1285101592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 BEAR CREEK BLVD",
            "city": "BEAR CREEK TOWNSHIP",
            "state": "PA",
            "postal_code": "187029752",
            "telephone_number": "570-574-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAR CREEK BLVD",
            "city": "BEAR CREEK TOWNSHIP",
            "state": "PA",
            "postal_code": "187029752",
            "telephone_number": "570-574-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "STEPHANIE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP019836",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN587980",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103612815-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "GLECO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allied Health Care Services (Allied Health Care Services-Bear Creek)
• Bear Creek Buck Township Ambulance Association
• Bear Creek Community Charter School
• Caitlin Ann Casey, LAT, ATC
• Geriatric Research & Consulting Group LLC
• Leah Marie Popple, PSY.D.
• Restore Abundant Health LLC
• Robin A Rodeghiero
• Amanda L Sekusky, D.O.
• Justin D Shiver

• Adult Health Nurse Practitioner in Bear Creek Township, PA
• Providers in Bear Creek Township, PA by specialty
• Adult Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.