Individual provider Active NPI

Scott G Lilly, MD

  • Hematology & Oncology Physician
  • Bixby, OK
National Provider Identifier
1841252145
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
21684 Issued in OK
Practice address
11911 S Memorial Dr
Bixby, OK 74008-2030
Phone
(918) 943-3790
Fax
(918) 943-3793
NPI assigned
Apr 4, 2006
Last updated
May 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 21684 OK Primary

Addresses

Primary practice location

11911 S Memorial Dr
Bixby, OK 74008-2030

Mailing address

PO Box 334
Bixby, OK 74008-0334
Phone (918) 970-2886

Other practice location 1

7890 E 106th Pl Ste V12
Tulsa, OK 74133-7407
Phone (918) 922-7686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20051026000834 OK Practitioner - Hematology/OncologyPractitioner - Internal Medicine 2567496490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Medical College of Ohio, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prophylaxis Healthcare LLCGroup PAC ID 3072784289, 26 clinicians

Practice addresses (Care Compare)

11911 S Memorial Dr
Bixby, OK 74008-2030
Phone (918) 943-3790

303 E Taft Ave
3 Axis Healthcare Sapulpa
Sapulpa, OK 74066-5651
Phone (918) 224-2222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21684OKMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prophylaxis Healthcare LLC CurrentSince Jul 1, 2018 Accepting new patients
Prophylaxis Healthcare LLC CurrentSince Jul 1, 2018 Accepting new patients
Ctca Physicans Group of Oklahoma, Inc Past Accepting new patients
City of Hope Medical Group of Illinois PLLC Past Accepting new patients

Locations

1407 SE Washington Blvd
Bartlesville, OK 74006
Phone (918) 335-2273

11911 S Memorial Dr
Bixby, OK 74008
Phone (918) 497-3700

211 S Mill St
Pryor, OK 74361
Phone (918) 825-3777

303 E Taft Ave
Ste 3
Sapulpa, OK 74066
Phone (918) 224-2222

Organizations & group practices 4

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1841252145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 334",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740080334",
            "telephone_number": "918-970-2886",
            "fax_number": "918-970-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 S MEMORIAL DR",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740082030",
            "telephone_number": "918-943-3790",
            "fax_number": "918-943-3793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7890 E 106th Pl Ste V12",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741337407",
            "country_code": "US",
            "telephone_number": "918-922-7686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLY",
        "first_name": "SCOTT",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OK",
            "license": "21684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bixby, OK

Sources for this page

Verify at the official NPI Registry.