Organization Active NPI

Defeo and Lilly, PC

  • Podiatrist
  • Allentown, PA
National Provider Identifier
1518069749
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC001701L Issued in PA
Legal business name
DEFEO AND LILLY, PC
Practice address
3131 College Heights Blvd
Suite 1500
Allentown, PA 18104-4877
Phone
(610) 821-0444
Fax
(610) 820-7006
NPI assigned
Sep 1, 2006
Last updated
Jan 9, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Authorized official

Name
Dr. William Thomas Defeo, DPMNPI 1164520524
Title
President
Phone
(610) 821-0444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC001701L PA Primary

Addresses

Primary practice location

3131 College Heights Blvd
Suite 1500
Allentown, PA 18104-4877

Mailing address

3131 College Heights Blvd
Suite 1500
Allentown, PA 18104-4877
Phone (610) 821-0444

Other identifiers 3

IdentifierTypeStateIssuer
0041080000OtherINDEPENDENCE BLUE CROSS
01188301OtherCAPITAL BLUE CROSS
013746OtherPAHIGHMARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040618001092 PA Part B Supplier - Clinic/Group Practice 9436134020 Receives reassigned benefits from 2 practitioners
Practice locations: Allentown, PA
O20100930065410 PA DME Supplier - Physician - Podiatry 9436134020 Practice locations: Allentown, PA

National Provider Directory

National Provider Directory

Locations

3131 College Heights Blvd
Ste 1500
Allentown, PA 18104
Phone (610) 821-0444

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389225600000",
    "number": "1518069749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD",
            "address_2": "SUITE 1500",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044877",
            "telephone_number": "610-821-0444",
            "fax_number": "610-820-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 COLLEGE HEIGHTS BLVD",
            "address_2": "SUITE 1500",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044877",
            "telephone_number": "610-821-0444",
            "fax_number": "610-820-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEFEO AND LILLY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2014-01-09",
        "status": "A",
        "authorized_official_last_name": "DEFEO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-821-0444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC001701L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENCE BLUE CROSS",
            "identifier": "0041080000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "01188301",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "013746",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.