Individual provider Active NPI

Madysen Taylar Lilley, FNP-BC

  • Family Nurse Practitioner
  • Troy, MO
National Provider Identifier
1487522744
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2025046828 Issued in MO
Practice address
172 Professional Pkwy
Troy, MO 63379-2823
Phone
(636) 462-6106
NPI assigned
Oct 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2025046828 MO Primary

Addresses

Primary practice location

172 Professional Pkwy
Troy, MO 63379-2823

Mailing address

53101 New River Dr
Lake Saint Louis, MO 63367-4424
Phone (636) 295-7623

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251105002856 MO Practitioner - Nurse Practitioner 2961992268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

172 Professional Pkwy
Troy, MO 63379-2823
Phone (636) 462-6106

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2025046828MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Medical Group Inc. CurrentSince Oct 30, 2025 Accepting new patients
SSM Medical Group, Inc. CurrentSince Oct 30, 2025 Accepting new patients

Locations

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

172 Professional Pkwy
Troy, MO 63379
Phone (636) 462-6106

Organizations & group practices 2

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.

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": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1487522744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53101 NEW RIVER DR",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633674424",
            "telephone_number": "636-295-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 PROFESSIONAL PKWY",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792823",
            "telephone_number": "636-462-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLEY",
        "first_name": "MADYSEN",
        "middle_name": "TAYLAR",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025046828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.