Dustin Lucas Lilly, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106670 Issued in FL

Practice address

4500 W Newberry Rd
Gainesville, FL 32607-2245

Phone

(352) 336-6000

Fax

(352) 332-0799

NPI assigned

Jul 17, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• The Orthopaedic Institute PA

  • Orthopaedic Surgery Physician
  • Gainesville, FL
  • NPI 1740373547
  Medicare reassignment NPD
• The Orthopaedic Institute, PA

  • Orthopaedic Surgery Physician
  • Jupiter, FL
  • NPI 1992569198
  NPD

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1609121607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072245",
            "telephone_number": "352-336-6000",
            "fax_number": "352-332-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072245",
            "telephone_number": "352-336-6000",
            "fax_number": "352-332-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "DUSTIN",
        "middle_name": "LUCAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-17",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifestyle Wellness, LLC
• Jennifer K. Light, MD
• Carolyn V Lightner, ARNP
• Robin Lillie
• Donna J Lilly, ARNP
• Shauna Renee Lillywhite, LMT
• Larissa A Lim, MD
• Nicole Lim, PA
• Marian C Limacher, MD
• Alpna R Limaye, M.D.

• Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.