Active NPI
Sarah Ellen Lilly, PA-C
- Physician Assistant
- Ripon, CA
National Provider Identifier
1740514082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1086595
- Practice address
- 150 Vera Ave
Ripon, CA 95366-2343 - Phone
- (209) 599-4211
- Fax
- (209) 599-7348
- NPI assigned
- Sep 18, 2009
- Last updated
- Sep 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1086595 | CA | Primary |
Addresses
Primary practice location
150 Vera Ave
Ripon, CA 95366-2343
Mailing address
150 Vera Ave
Ripon, CA 95366-2343
Phone (209) 599-4211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1086595 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Calmglow, Inc | Past | Accepting new patients |
Organizations & group practices 1
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": "1253232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253232000000",
"number": "1740514082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 VERA AVE",
"city": "RIPON",
"state": "CA",
"postal_code": "953662343",
"telephone_number": "209-599-4211",
"fax_number": "209-599-7348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 VERA AVE",
"city": "RIPON",
"state": "CA",
"postal_code": "953662343",
"telephone_number": "209-599-4211",
"fax_number": "209-599-7348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLY",
"first_name": "SARAH",
"middle_name": "ELLEN",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-18",
"last_updated": "2009-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "1086595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ripon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.