John Lillegraven, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0116037328 Issued in VA

Practice address

825 Fairfax Ave
Norfolk, VA 23507-1914

Phone

(757) 446-5955

NPI assigned

Mar 23, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, HI, CA3 enrollments

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 3

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Plumas Health Care DistrictGroup PAC ID 4587576889, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eastern Plumas Hospital - Portola Campus Hospital, Portola, CA, CCN 051300

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Eastern Plumas Health Care District

  • Critical Access Hospital
  • Portola, CA
  • NPI 1326044140
  Medicare reassignment Care Compare group
• Kau Hospital

  • Rural Health Clinic/Center
  • Pahala, HI
  • NPI 1144304338
  Medicare reassignment NPD
• Tulalip Tribes of Washington

  • General Practice Physician
  • Tulalip, WA
  • NPI 1770531501

  TX

  Medicare reassignment NPD
• Eastern Plumas Health Care District

  • Critical Access Hospital
  • Portola, CA
  • NPI 1982600920
  NPD
• Eastern Plumas Health Care Home Health

  • Home Health Agency
  • Portola, CA
  • NPI 1043216849
  NPD
• Kau Hospital

  • Rural Health Clinic/Center
  • Pahoa, HI
  • NPI 1285450163
  NPD
• Tulalip Tribes of Washington

  • Mental Health Counselor
  • Tulalip, WA
  • NPI 1194558478
  NPD
• Tulalip Tribes of Washington

  • Optometrist
  • Tulalip, WA
  • NPI 1831946797
  NPD

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

• Eastern Plumas Health Care District

  • Critical Access Hospital
  • Portola, CA
  • NPI 1326044140
  Care Compare affiliation
• Eastern Plumas Health Care District

  • Critical Access Hospital
  • Portola, CA
  • NPI 1982600920
  Care Compare affiliation

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1427634872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12007 WINWOOD LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770245014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-5955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Meeting House Ln",
            "address_purpose": "LOCATION",
            "city": "Southampton",
            "state": "NY",
            "postal_code": "119685009",
            "country_code": "US",
            "telephone_number": "631-726-0409",
            "fax_number": "631-726-0396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLEGRAVEN",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "MD-24592",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116037328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifestyle Solutions LLC
• Lifewell Psychotherapy LLC
• Clay Kingsley Lifton, M.D.
• Light and Life Therapy LLC
• Alexander Cameron Liles, MD
• Christina Lee Lilli, DMD
• Edward L Lilly, MD
• Jerilowe Lim, PT, DPT
• Keith Lim, PHARMD
• Rochelle Lincoln

• Family Medicine Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.