David B Lillie, M.D.
Individual provider Active NPI Specialist · Kenmore, NY
NPI 1952306201 · NPPES record last updated Aug 19, 2019
Key facts
- NPI
- 1952306201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 145776-1 (NY)
- Practice address
- 3800 Delaware Ave
Ste 104
Kenmore, NY 14217-1094 - Phone
- (716) 873-3828
- Fax
- (716) 873-5463
- NPI assigned
- Jun 14, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Urology
- Education
- Wayne State University School of Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Brain and Spine Medical Services PLLC
Practice addresses (Care Compare)
400 International Dr
Williamsville, NY 14221-5771
Phone (716) 631-3555
Hospital & facility affiliations
- Kenmore Mercy Hospital
- Kaleida Health
- Sisters of Charity Hospital
- Mount St. Mary'S Hospital & Health Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- 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 |
|---|---|---|---|---|
| I20050210000112 | NY | Practitioner - Urology | 3274584933 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 145776-1 | NY | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brain & Spine Medical Services PLLC | Current |
Accepting new patients | |
| Dia Invision Health | Current |
Accepting new patients |
Locations
3800 Delaware Ave
Ste 104
Kenmore, NY 14217
Phone (716) 873-3828
400 International Dr
Williamsville, NY 14221
Phone (716) 631-1516
Interoperability endpoints
- dlillie@invisionhealthbrainandspine.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 145776-1 | NY | Yes |
Addresses
Primary practice location
3800 Delaware Ave
Ste 104
Kenmore, NY 14217-1094
Mailing address
400 International Dr
Williamsville, NY 14221-5771
Phone (716) 873-3828
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1900426 | Other | NY | IHA |
| 00010104801 | Other | NY | UNIVERA |
| 00607167 | Medicaid | NY | |
| 040426001716 | Other | NY | FIDELIS |
Other providers in Kenmore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2019. 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.