Lilly Ann Stallmer, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601012298 Issued in MI

Practice address

145 Michigan St NE Ste 3100
Grand Rapids, MI 49503-2563

Phone

(616) 644-3574

NPI assigned

Jan 29, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lilly Ann Stallmer Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cancer and Hematology Centers of Western Mi, P.C.Group PAC ID 4082526793, 109 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Cancer & Hematology Centers of Western Mi, P.C.

  • Specialist
  • Grand Rapids, MI
  • NPI 1528018389
  Medicare reassignment Care Compare group
• Cancer & Hematology Centers of Western Mi, P.C.

  • Rheumatology Physician
  • Grand Rapids, MI
  • NPI 1467017434
  NPD

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

• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1457113052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 MICHIGAN ST NE STE 3100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032563",
            "telephone_number": "616-644-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MICHIGAN ST NE STE 3100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032563",
            "telephone_number": "616-644-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLMER",
        "first_name": "LILLY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILLY",
            "last_name": "STALLMER",
            "middle_name": "ANN",
            "credential": "STELLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brett Stahl
• Anders Ross-Brandt Staky
• Kylee Christena Staky, DPT
• Justin R Staley, DO
• Morgan Staley, CRNA
• Halee Stalmack
• Daniel J Stalsonburg, PA
• Benjamin Stam
• Daniella J Stambaugh
• Gracie Linne Stamp

• Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.