NPIMap

Organization Active NPI

Lilac Healthcare LLC

  • Obstetrics & Gynecology Physician
  • Chandler, AZ
National Provider Identifier
1730724477
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
LILAC HEALTHCARE LLC
Practice address
655 S Dobson Rd Ste A101
Chandler, AZ 85224-5675
Phone
(833) 454-5226
NPI assigned
Nov 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Authorized official

Name
Mr. Sean M Housley
Title
Practice Administrator
Phone
(833) 454-5226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

655 S Dobson Rd Ste A101
Chandler, AZ 85224-5675

Mailing address

655 S Dobson Rd Ste 101
Chandler, AZ 85224-5668
Phone (833) 454-5226

Other names 1

  • Lilac Ob-gyn Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200129002347 AZ Part B Supplier - Clinic/Group Practice 7911333596 Receives reassigned benefits from 24 practitioners
Practice locations: Chandler, AZ

National Provider Directory

National Provider Directory

Locations

655 S Dobson Rd
Ste A101
Chandler, AZ 85224
Phone (480) 855-5900

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1730724477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S DOBSON RD STE 101",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245668",
            "telephone_number": "833-454-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S DOBSON RD STE A101",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245675",
            "telephone_number": "833-454-5226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILAC HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-15",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "HOUSLEY",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "833-454-5226",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lilac Ob-gyn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.