Scott G Lilly, MD – Hematology & Oncology Physician

Key facts

NPI: 1841252145
Entity type: Individual (NPI type 1)
Primary specialty: Hematology & Oncology Physician 207RH0003X
License: 21684 (OK)
Practice address: 11911 S Memorial Dr
Bixby, OK 74008-2030
Phone: (918) 943-3790
Fax: (918) 943-3793
NPI assigned: Apr 4, 2006
Sex: Male
Sole proprietor: No

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 and National Provider Directory roles.

Prophylaxis Healthcare LLC Multi-Specialty Clinic/Center · Bixby, OK · NPI 1538453923

Medicare reassignment Care Compare group NPD OK
Prophylaxis Healthcare LLC Community/Behavioral Health Agency · Bixby, OK · NPI 1285438317

NPD
Ctca Physicans Group of Oklahoma, Inc Specialist · Tulsa, OK · NPI 1053309591

NPD (past)
City of Hope Medical Group of Illinois PLLC Specialist · Zion, IL · NPI 1548258072

NPD (past)

Medicare Care Compare profile

Specialty: Hematology/Oncology
Also: Internal Medicine
Education: Medical College of Ohio, 1991
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Prophylaxis Healthcare LLC (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

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OK
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20051026000834	OK	Practitioner - Hematology/Oncology Practitioner - Internal Medicine	2567496490	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
21684	OK	MD	Hematology & Oncology Physician

Practice roles

Organization	Status	New patients
Prophylaxis Healthcare LLC	Current since Jul 1, 2018	Accepting new patients
Prophylaxis Healthcare LLC	Current since Jul 1, 2018	Accepting new patients
City of Hope Medical Group of Illinois PLLC	Past	Accepting new patients
Ctca Physicans Group of Oklahoma, Inc	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

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Hematology & Oncology Physician	207RH0003X	21684	OK	Yes

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 9, 2024.

{
    "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

All providers in Bixby, OK · Hematology & Oncology Physician in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.