Individual provider Active NPI

Deacon Lile, MD

  • Surgery Physician
  • Newark, DE
National Provider Identifier
1558773473
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C1-0027227 Issued in DE
Practice address
4735 Ogletown Stanton Rd Ste 3301
Newark, DE 19713-7021
Phone
(302) 623-4370
Fax
(302) 623-4375
NPI assigned
May 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MT206082 PA
Surgical Critical Care Physician 2086S0102X C1-0027227 DE
Surgery Physician 208600000X C1-0027227 DE Primary

Addresses

Primary practice location

4735 Ogletown Stanton Rd Ste 3301
Newark, DE 19713-7021

Mailing address

1008 S Spring Ave Ste 1600
Saint Louis, MO 63110-2520
Phone (215) 707-2000

Other practice location 1

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 977-4440

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dlile335175@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240930000012 DE Practitioner - General Surgery 7012201353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Temple University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

501 W 14TH St Wilmington Hospital
CCHS Surgery
Wilmington, DE 19801-1013
Phone (302) 623-3850

Hospital & facility affiliations

  • Christiana Hospital Hospital, Newark, DE, CCN 080001
  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007
  • Union Hospital of Cecil County Hospital, Elkton, MD, CCN 210032

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C1-0027227DEMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Sep 16, 2024 Accepting new patients
Christiana Care Health Services, Inc Current Accepting new patients
Christiana Care Health Services, Inc Surgery CurrentSince Sep 16, 2024 Accepting new patients
Christiana Care Health Services, Inc Surgery Past Accepting new patients
Christiana Care Health Services, Inc. Past Accepting new patients

Locations

4735 Ogletown Stanton Rd
Ste 3301
Newark, DE 19713
Phone (302) 623-4370

4701 Ogletown Stanton Rd
Ste 1500
Newark, DE 19713
Phone (302) 623-4343

501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411

501 W 14th St
#4154
Wilmington, DE 19801
Phone (302) 428-4175

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

Interoperability endpoints

  • Direct secure messaging: dlile335175@direct-ehr-ssmhc.com
  • Direct secure messaging: dlile1057996@direct.carenet.org

Organizations & group practices 5

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": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1558773473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 S SPRING AVE STE 1600",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102520",
            "telephone_number": "215-707-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 OGLETOWN STANTON RD STE 3301",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197137021",
            "telephone_number": "302-623-4370",
            "fax_number": "302-623-4375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041016",
            "country_code": "US",
            "telephone_number": "314-977-4440",
            "fax_number": "314-977-1877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILE",
        "first_name": "DEACON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT206082",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "DE",
            "license": "C1-0027227",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DE",
            "license": "C1-0027227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlile335175@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "dlile335175@direct-ehr-ssmhc.com",
            "address_1": "1201 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1201 S Grand Blvd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631041016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.