NPIMap

Individual provider Active NPI

Timothy J. Lilly, D.O.

  • Internal Medicine Physician
  • Grove City, PA
National Provider Identifier
1649258765
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS006328L Issued in PA
Practice address
432 Hillcrest Ave
Suite 3
Grove City, PA 16127-1708
Phone
(724) 615-9193
Fax
(724) 458-6689
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS006328L PA Primary

Addresses

Primary practice location

432 Hillcrest Ave
Suite 3
Grove City, PA 16127-1708

Mailing address

432 Hillcrest Ave
Suite 3
Grove City, PA 16127-1708
Phone (724) 615-9193

Other identifiers 1

IdentifierTypeStateIssuer
0011775800010MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050830000629 PA Practitioner - Internal Medicine 8921039850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Butler Medical ProvidersGroup PAC ID 7416840160, 355 clinicians
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

24 Doctors LN
Clarion, PA 16214-8574

316 Allegheny Blvd
Suite B
Franklin, PA 16323-6208
Phone (814) 432-7200

675 N Broad St Ext
Suite 3
Grove City, PA 16127-5805
Phone (833) 906-0108

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Butler Medical Providers Current Accepting new patients
Butler Medical Providers CurrentSince Jun 1, 2015 Accepting new patients
Butler Medical Providers CurrentSince Jun 1, 2015 Accepting new patients
Butler Medical Providers Past Accepting new patients

Locations

24 Doctors Ln
Ste 201
Clarion, PA 16214
Phone (833) 684-1898

675 N Broad Street Ext
Ste 3
Grove City, PA 16127
Phone (724) 458-0232

432 Hillcrest Ave
Ste 3
Grove City, PA 16127
Phone (724) 615-9193

Interoperability endpoints

  • Direct secure messaging: timothy.lilly@direct-address.net

Organizations & group practices 4

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 11

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483574400000",
    "number": "1649258765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 HILLCREST AVE",
            "address_2": "SUITE 3",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161271708",
            "telephone_number": "724-615-9193",
            "fax_number": "724-458-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 HILLCREST AVE",
            "address_2": "SUITE 3",
            "city": "GROVE CITY",
            "state": "PA",
            "postal_code": "161271708",
            "telephone_number": "724-615-9193",
            "fax_number": "724-458-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "TIMOTHY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2017-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS006328L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011775800010",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove City, PA

Sources for this page

Verify at the official NPI Registry.