Jamie Maria Lilly, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

69994 Issued in MT

Practice address

500 West Broadway
Missoula, MT 59802

Phone

(406) 329-5615

Fax

(406) 329-2791

NPI assigned

Dec 12, 2006

Last updated

May 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Jamie Maria McCormack Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VT, MT2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jlilly984141@wm.providencedirect.org

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.

• Providence Health & Services Mt

  dba St Patrick Hospital Rehab

  • Rehabilitation Hospital Unit
  • Missoula, MT
  • NPI 1144319138
  Medicare reassignment Care Compare group
• University of Vermont Medical Center Inc

  dba Uvm Medical Center

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615
  Medicare reassignment NPD
• Providence Health & Services Mt

  dba PMG MT Trauma Services

  • Emergency Medical Services (Emergency Medicine) Physician
  • Missoula, MT
  • NPI 1124268966
  NPD
• Providence Health & Services Mt

  dba Providence Medical Group Montana

  • Family Medicine Physician
  • Missoula, MT
  • NPI 1215222617
  NPD

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

• Providence Health & Services Mt

  dba Providence St Patrick Hospital

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1023032588
  Care Compare affiliation
• Providence Health & Services Mt

  dba Montana Cancer Center at Providence St. Patrick Hospital

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1326483587

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  dba St Patrick Hospital Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Missoula, MT
  • NPI 1366185928

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  dba St Patrick Hospital Psych

  • Psychiatric Hospital Unit
  • Missoula, MT
  • NPI 1619058302
  Care Compare affiliation

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1922168517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WEST BROADWAY",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024096",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WEST BROADWAY",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59802",
            "telephone_number": "406-329-5615",
            "fax_number": "406-329-2791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "University of Vermont Medical center",
            "address_2": "111 Colchester Ave, Fletcher 454",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054010540",
            "country_code": "US",
            "telephone_number": "802-847-4152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "University of Vermont Medical center",
            "address_2": "111 Colchester Ave, Fletcher 454",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054010540",
            "country_code": "US",
            "telephone_number": "802-847-4152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_2": "DHMC Department of CT Surgery",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037561000",
            "country_code": "US",
            "telephone_number": "603-650-7390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LILLY",
        "first_name": "JAMIE",
        "middle_name": "MARIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "69994",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VT",
            "license": "055-0031195",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "001000729",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0670",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30207723",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000375",
            "state": "VT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlilly984141@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 West Broadway",
            "city": "MISSOULA",
            "state": "MT",
            "country_code": "US",
            "postal_code": "59802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "MCCORMACK",
            "middle_name": "MARIA",
            "credential": "WORTMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie Lynn Lighter, CNM, WHNP
• Lighthouse Speech Therapy PLLC
• Lightspace, Inc.
• John Craig Lilburn, MSW, LCSW
• Hannah Lillie, P-LCPC, NCC
• Lily Gervais LCSW, Lac PLLC
• Limen Integrative Therapy
• Lincare Inc.
• Patricia A. Lincoln, LCSW,LAC
• Gregar Howard Lind, M.D.

• Physician Assistant in Missoula, MT
• Providers in Missoula, MT by specialty
• Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (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.