Individual provider Active NPI

Rachel German Lilly, PHD

  • Psychologist
  • Fort Wayne, IN
National Provider Identifier
1891223020
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20043482A Issued in IN
Practice address
2700 Lafayette St
Fort Wayne, IN 46806-1100
Phone
(260) 481-2770
NPI assigned
Jun 1, 2017
Last updated
Oct 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20043482A IN Primary
Psychologist 103T00000X NU
Psychologist 103T00000X PS018570 PA
Clinical Child & Adolescent Psychologist 103TC2200X NU

Addresses

Primary practice location

2700 Lafayette St
Fort Wayne, IN 46806-1100

Mailing address

11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701

Other practice location 1

21 Geisinger Ln
Lewistown, PA 17044-3400
Phone (717) 242-4200

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address rgerman148775@direct.geisinger.edu Direct
Direct Messaging Address rlilly464367@Direct.Parkviewexchange.com
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/
FHIR URL https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210629000163 IN Practitioner - Clinical Psychologist 5294085239 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.37 of 100Reported as group
Quality
80.38
Promoting interoperability
100
Improvement activities
40
Cost
74.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20043482AINMDPsychologist
PS018570PAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Center Inc CurrentSince Jul 10, 2021 Accepting new patients
Park Center Inc CurrentSince Jul 10, 2021 Accepting new patients
Parkview Health System Inc Current Accepting new patients
Parkview Health System, Inc. CurrentSince Aug 15, 2021 Accepting new patients

Locations

11109 Parkview Plaza Dr
#117
Fort Wayne, IN 46845
Phone (260) 266-6012

2700 Lafayette St
Fort Wayne, IN 46806
Phone (219) 745-5415

909 E State Blvd
Fort Wayne, IN 46805
Phone (260) 481-2718

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

Interoperability endpoints

  • Direct secure messaging: rlilly464367@direct.parkviewexchange.com

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": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1891223020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR # 117",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 LAFAYETTE ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468061100",
            "telephone_number": "260-481-2770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Geisinger Ln",
            "address_purpose": "LOCATION",
            "city": "Lewistown",
            "state": "PA",
            "postal_code": "170443400",
            "country_code": "US",
            "telephone_number": "717-242-4200",
            "fax_number": "717-242-4212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLY",
        "first_name": "RACHEL",
        "middle_name": "GERMAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20043482A",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS018570",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgerman148775@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21 Geisinger Ln",
            "city": "Lewistown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170443400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rlilly464367@Direct.Parkviewexchange.com",
            "affiliation": "N",
            "address_1": "1818 Carew St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1818 Carew St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicprod-mobile.parkview.com/FHIR/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "1818 Carew St",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468054788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.