Dale Blake Lilly, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

17041 Issued in WV

Practice address

2823 3Rd Ave
Huntington, WV 25702-1423

Phone

(304) 523-3937

Fax

(304) 523-3945

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Ophthalmology

Education

JC Edwards School of Medicine, Marshall University, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Marys Medical Center Hospital, Huntington, WV, CCN 510007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Lilly Eye Care, Inc.

  • Medical Specialty Clinic/Center
  • Huntington, WV
  • NPI 1053495820
  Medicare reassignment NPD Authorized official

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

• St. Mary'S Medical Center Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1164492195
  Care Compare affiliation

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365033600000",
    "number": "1376557918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021423",
            "telephone_number": "304-523-3937",
            "fax_number": "304-523-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021423",
            "telephone_number": "304-523-3937",
            "fax_number": "304-523-3945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "DALE",
        "middle_name": "BLAKE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WV",
            "license": "17041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV STATE",
            "identifier": "17041",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096101000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0219534",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dawn Lightle
• Chase M Liles
• Lilly Eye Care, Inc.
• Brandon Lilly
• Cory Lilly, PR
• Dani Lilly
• Julia Lilly
• Lily'S Place, Inc.
• Lilys Place Family Center
• Susang Nina Limbu, M.D.

• Ophthalmology Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Ophthalmology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.