Individual provider Active NPI

Michael Peter Lilly, MD

  • Vascular Surgery Physician
  • Baltimore, MD
National Provider Identifier
1700887916
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
D37902 Issued in MD
Practice address
827 Linden Ave
Baltimore, MD 21201
Phone
(410) 225-8000
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X D37902 MD Primary

Addresses

Primary practice location

827 Linden Ave
Baltimore, MD 21201

Mailing address

920 Elkridge Landing Rd
Linthicum, MD 21090-2917
Phone (443) 462-5010

Other identifiers 1

IdentifierTypeStateIssuer
296881900MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20100322000165 MD Practitioner - Vascular SurgeryPractitioner - General Surgery 6204961865 Reassigns benefits to 3 organizations
I20240923001044 DC Practitioner - General Surgery 6204961865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Georgetown University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-5191

827 Linden Ave
Baltimore, MD 21201-4606

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D37902MDMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Surgcial Assoc PA Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mlilly6274@direct.umm.edu

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 5

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1700887916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 ELKRIDGE LANDING RD",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902917",
            "telephone_number": "443-462-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 LINDEN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21201",
            "telephone_number": "410-225-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "MICHAEL",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MD",
            "license": "D37902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296881900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.