NPIMap

Organization Active NPI

Lily Internal Medicine and Associates,LLC

  • Medical Specialty Clinic/Center
  • Milford, DE
National Provider Identifier
1790927945
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
C10007397 Issued in DE
Legal business name
LILY INTERNAL MEDICINE AND ASSOCIATES,LLC
Practice address
1019 Mattlind Way
Milford, DE 19963-5369
Phone
(302) 424-1000
Fax
(866) 662-5282
NPI assigned
Apr 2, 2009
Last updated
Jan 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Authorized official

Name
Dr. Ifeanyi Afam Udezulu, M.D.,PH.D.NPI 1275524944
Title
Owner/Physician
Phone
(302) 632-7610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X C10007397 DE Primary

Addresses

Primary practice location

1019 Mattlind Way
Milford, DE 19963-5369

Mailing address

2720 Fast Landing Rd
Dover, DE 19901-3105
Phone (302) 736-8877

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090429000552 DE Part B Supplier - Clinic/Group Practice 6204984321 Receives reassigned benefits from 1 practitioner
Practice locations: Dover, DE

National Provider Directory

National Provider Directory

Locations

811 Monroe Ter
Dover, DE 19904
Phone (302) 424-1000

1019 Mattlind Way
Milford, DE 19963
Phone (302) 424-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4001/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1790927945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 FAST LANDING RD",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013105",
            "telephone_number": "302-736-8877",
            "fax_number": "302-736-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 MATTLIND WAY",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199635369",
            "telephone_number": "302-424-1000",
            "fax_number": "866-662-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILY INTERNAL MEDICINE AND ASSOCIATES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-02",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A",
        "authorized_official_last_name": "UDEZULU",
        "authorized_official_first_name": "IFEANYI",
        "authorized_official_middle_name": "AFAM",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "302-632-7610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "DE",
            "license": "C10007397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.