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LILLIE GRANTHAM PA
NPI 1023818143
Physician Assistant in Georgetown, TX

Active since March 17, 2025PECOS EnrolledAccepts Medicare Assignment
4945 WILLIAMS DR, GEORGETOWN, TX 78633(512) 819-0500 Get Directions Write a Review

NPPES record last updated: December 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 2, 2025, Sep 16, 2025, Mar 17, 2025 (3 updates tracked since 2025).

About Lillie Grantham Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LILLIE GRANTHAM PA (NPI 1023818143) is an individual physician assistant in Georgetown, Texas, licensed in Texas (PA19201) and active in the NPI registry since March 2025. She is enrolled in Medicare PECOS, is affiliated with Baylor Scott & White Medical Center - Round Rock, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1023818143
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameLILLIE GRANTHAMCredential: PA
Location Address4945 WILLIAMS DRGeorgetown, TX 78633-2008
Mailing AddressPo Box 844658Dallas, TX 75284-4658 · (800) 994-0371 · Fax (254) 215-9722
Phone(512) 819-0500
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateMarch 17, 2025
Last NPPES UpdateDecember 2, 20253 updates tracked since enumeration
NPPES CertifiedDecember 2, 2025
✔ NPI 1023818143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA19201
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4945 WILLIAMS DR, Georgetown, TX 78633
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lillie Grantham Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID446767537
PECOS Enrollment IDI20250724001592
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baylor Scott & White Medical Center - Round Rock

Acute Care Hospitals · Round Rock, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670034
Location300 University BlvdRound Rock, TX 78664 · Williamson County
Emergency services Birthing friendly

Baylor Scott & White Medical Center Pflugerville

Acute Care Hospitals · Pflugerville, TX
OwnershipVoluntary non-profit - Private
CMS Certification Number670128
Location2600 East Pflugerville ParkwayPflugerville, TX 78660 · Travis County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78633 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.
Pharmacy (Community/Retail Pharmacy)
4945 WILLIAMS DR
GEORGETOWN, TX 78633
Williamson County (512) 942-3302
ANITA D'MELLO M.D.
Internal Medicine
4945 WILLIAMS DR
GEORGETOWN, TX 78633
Williamson County (512) 819-0500
MR. ELIAS VICTOR I IMPENS MD
Internal Medicine
4945 WILLIAMS DR
GEORGETOWN, TX 78633
Williamson County (254) 724-2111
DR. MATTHEW THOMAS WALTERS D.C.
Chiropractor
4945 WILLIAMS DR
GEORGETOWN, TX 78633
Williamson County (512) 819-0500
OMER FATIH YAVUZ MD
Internal Medicine
4945 WILLIAMS DR
GEORGETOWN, TX 78633
Williamson County (512) 819-0500
MITHULA RAO GOPALAM
Internal Medicine
4945 WILLIAMS DR
GEORGETOWN, TX 78633
Williamson County (512) 819-0500
SUPRAJA R. GULLA MD
Internal Medicine
4945 WILLIAMS DR
GEORGETOWN, TX 78633
Williamson County (317) 962-2894
SADIA RASHID M.D.
Internal Medicine
4945 WILLIAMS DR
GEORGETOWN, TX 78633
Williamson County (512) 819-0500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lillie Grantham's NPI number?

The NPI number for Lillie Grantham is 1023818143. It was assigned to this individual provider in the NPPES registry on March 17, 2025.

Where is Lillie Grantham located?

Lillie Grantham practices at 4945 Williams Dr, Georgetown, TX 78633. The listed phone number is (512) 819-0500.

What is Lillie Grantham's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Lillie Grantham enrolled in Medicare?

Yes. Lillie Grantham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lillie Grantham accept?

Health plans from Blue Cross and Blue Shield of Texas list Lillie Grantham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Lillie Grantham affiliated with any hospitals?

According to CMS data, Lillie Grantham is affiliated with Baylor Scott & White Medical Center - Round Rock and Baylor Scott & White Medical Center Pflugerville.

When was this NPI record last updated?

The NPPES record for Lillie Grantham was last updated on December 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.