Individual provider Active NPI

Javier Lillo, M.D.

  • General Practice Physician
  • Ponce, PR
National Provider Identifier
1578877973
Registry record updated Sep 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
18804 Issued in PR
Practice address
621 Calle Aceitillo
Urb. Los Caobos
Ponce, PR 00716-2602
Phone
(787) 623-5420
NPI assigned
Jul 28, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 18804 PR Primary

Addresses

Primary practice location

621 Calle Aceitillo
Urb. Los Caobos
Ponce, PR 00716-2602

Mailing address

621 Calle Aceitillo
Urb. Los Caobos
Ponce, PR 00716-2602
Phone (787) 396-9001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, PR2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20160817003049 TX Practitioner - General Practice 8426343211
I20240718001625 PR Practitioner - General Practice 8426343211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ER Specialized Care LLCGroup PAC ID 6507122967, 19 clinicians

Practice addresses (Care Compare)

Avenida Juan Ponce de Leon Parada
37 Hospital Auxilio Mutuo
Hato Rey, PR 00919
Phone (787) 758-2000

Hospital & facility affiliations

  • Auxilio Mutuo Hospital Hospital, San Juan, PR, CCN 400016

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
ER Specialized Care LLC CurrentSince May 4, 2024 Accepting new patients

Organizations & group practices 1

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 1

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": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410048000000",
    "number": "1578877973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 CALLE ACEITILLO",
            "address_2": "URB. LOS CAOBOS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162602",
            "telephone_number": "787-396-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 CALLE ACEITILLO",
            "address_2": "URB. LOS CAOBOS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007162602",
            "telephone_number": "787-623-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLO",
        "first_name": "JAVIER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2014-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

Verify at the official NPI Registry.