Individual provider Active NPI

Victoria A Lillis, PA-C

  • Physician Assistant
  • Newport, VT
National Provider Identifier
1831787647
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
186 Medical Village Dr
Newport, VT 05855-8537
Phone
(802) 334-3520
NPI assigned
Jan 7, 2021
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X VT Primary

Addresses

Primary practice location

186 Medical Village Dr
Newport, VT 05855-8537

Mailing address

189 Prouty Dr
Newport, VT 05855-9820

Other names 1

  • Victoria A Lillis Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20210423001817 VT Practitioner - Physician Assistant 1052729449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

186 Medical Village Dr
Newport, VT 05855-8537
Phone (802) 334-3520

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.39 of 100Reported as group
Quality
72.51
Promoting interoperability
100
Improvement activities
40
Cost
55.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Hospital & Health Center Inc CurrentSince May 15, 2021 Accepting new patients
North Country Hospital & Health Center Inc Current Accepting new patients
North Country Hospital & Health Center Inc CurrentSince May 15, 2021 Accepting new patients

Locations

186 Medical Village Dr
#1
Newport, VT 05855
Phone (802) 334-3262

189 Prouty Dr
Newport, VT 05855
Phone (802) 334-3569

186 Medical Village Dr
Newport, VT 05855
Phone (802) 334-3520

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1831787647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 PROUTY DR",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 MEDICAL VILLAGE DR",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058558537",
            "telephone_number": "802-334-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLIS",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "LILLIS",
            "middle_name": "A",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport, VT

Sources for this page

Verify at the official NPI Registry.