Individual provider Active NPI

Carol Lilly, MD

  • Pediatrics Physician
  • Tampa, FL
National Provider Identifier
1740290410
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME67209 Issued in FL
Practice address
2 Tampa General Cir
Tampa, FL 33606-3603
Phone
(813) 259-8700
Fax
(813) 259-8862
NPI assigned
Aug 8, 2006
Last updated
Jul 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME67209 FL Primary

Addresses

Primary practice location

2 Tampa General Cir
Tampa, FL 33606-3603

Mailing address

PO Box 917770
Orlando, FL 32891-7770

Other identifiers 2

IdentifierTypeStateIssuer
26221OtherFLBLUE CROSS BLUE SHIELD
376331500MedicaidFL

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150630002051 FL Practitioner - Pediatric Medicine 2668784836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2 Tampa General Cir
Tampa, FL 33606-3603
Phone (813) 259-8700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince May 1, 2015 Accepting new patients
University Medical Service Association Inc Pediatrics CurrentSince May 1, 2015 Accepting new patients
University Medical Service Association Inc Current Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

800 6th St S
St Petersburg, FL 33701
Phone (727) 767-4150

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

12901 N 30th St
Tampa, FL 33612
Phone (813) 974-0703

2 Tampa General Cir
Fl 2
Tampa, FL 33606
Phone (813) 209-8596

Interoperability endpoints

  • Direct secure messaging: clilly1259981@direct.hopkinsmedicine.org
  • Direct secure messaging: clilly8121@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1740290410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TAMPA GENERAL CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063603",
            "telephone_number": "813-259-8700",
            "fax_number": "813-259-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLY",
        "first_name": "CAROL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME67209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "26221",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376331500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.