Tahnee Lilly

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

840 S Magnolia Ave Unit 1405
Ontario, CA 91762-4783

Phone

(951) 288-2641

NPI assigned

Nov 9, 2021

Sex

Female

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 CA

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Emergency MedicineGroup PAC ID 8628128196, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Southern California Emergency Medicine

  • Urgent Care Clinic/Center
  • San Bernardino, CA
  • NPI 1639314255
  Medicare reassignment Care Compare group
• Southern California Emergency Medicine

  • Urgent Care Clinic/Center
  • Riverside, CA
  • NPI 1063191575
  NPD
• Southern California Emergency Medicine

  • Urgent Care Clinic/Center
  • Redlands, CA
  • NPI 1457888034
  NPD

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1730845280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S MAGNOLIA AVE UNIT 1405",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917624783",
            "telephone_number": "951-288-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S MAGNOLIA AVE UNIT 1405",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917624783",
            "telephone_number": "951-288-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "TAHNEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymund Rigor Libang, RCP
• Benicia Lie, BCBA
• Catareya P Liep, MD
• Life Care Medical Center, Inc.
• Life Medical Center Inc.
• Katherine Lily
• Alexis Sara Lim
• Alyssah Lim
• Charmaine Lim, OT
• Christine Lim

• Physician Assistant in Ontario, CA
• Providers in Ontario, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.