NPIMap

Individual provider Active NPI

David B Lillie, M.D.

  • Specialist
  • Kenmore, NY
National Provider Identifier
1952306201
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
145776-1 Issued in 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
Last updated
Aug 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 145776-1 NY Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050210000112 NY Practitioner - Urology 3274584933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

Practice addresses (Care Compare)

400 International Dr
Williamsville, NY 14221-5771
Phone (716) 631-3555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
145776-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Brain & Spine Medical Services PLLC CurrentSince Jan 26, 2019 Accepting new patients
Dia Invision Health CurrentSince Jan 26, 2019 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

  • Direct secure messaging: dlillie@invisionhealthbrainandspine.medentdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 10

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1952306201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERNATIONAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215771",
            "telephone_number": "716-873-3828",
            "fax_number": "716-873-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 DELAWARE AVE",
            "address_2": "STE 104",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171094",
            "telephone_number": "716-873-3828",
            "fax_number": "716-873-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLIE",
        "first_name": "DAVID",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "145776-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

Verify at the official NPI Registry.