Individual provider Active NPI

Lily Phan, MD

  • Anesthesiology Physician
  • Elizabeth, NJ
National Provider Identifier
1871912907
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA10316400 Issued in NJ
Practice address
225 Williamson St
Elizabeth, NJ 07202
Phone
(908) 994-5204
NPI assigned
Apr 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X 25MA10316400 NJ Primary

Addresses

Primary practice location

225 Williamson St
Elizabeth, NJ 07202

Mailing address

572 Westminster Ave
Elizabeth, NJ 07208-2207
Phone (480) 332-9734

Other practice location 1

185 S Orange Ave
MSB G-538
Newark, NJ 07103-2757
Phone (973) 972-5682

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20180920002182 NJ Practitioner - Anesthesiology 1850642463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Ohio State University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Observation Associates LLCGroup PAC ID 5193137503, 995 clinicians

Practice addresses (Care Compare)

225 Williamson St
Elizabeth, NJ 07202-3625
Phone (615) 972-9119

Hospital & facility affiliations

  • Trinitas Regional Medical Center Hospital, Elizabeth, NJ, CCN 310027

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.87
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10316400NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC Anesthesiology CurrentSince Dec 10, 2023 Accepting new patients

Locations

1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1871912907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 WESTMINSTER AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082207",
            "telephone_number": "480-332-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 WILLIAMSON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "07202",
            "telephone_number": "908-994-5204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "185 S Orange Ave",
            "address_2": "MSB G-538",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071032757",
            "country_code": "US",
            "telephone_number": "973-972-5682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAN",
        "first_name": "LILY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA10316400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.