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LILY GUTNIK MD MPH
NPI 1053690099
Surgery - Surgical Oncology in Birmingham, AL

Active since August 09, 2011PECOS EnrolledAccepts Medicare Assignment
84.17/100
CMS Quality Rating
1808 7TH AVE S BDB515, BIRMINGHAM, AL 35294(205) 975-5477(205) 975-5971 Get Directions Write a Review

NPPES record last updated: December 29, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 11, 2022, Apr 1, 2016 (2 updates tracked since 2016).

About Lily Gutnik Md Mph NPPES

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

LILY GUTNIK MD MPH (NPI 1053690099) is an individual surgical oncology provider in Birmingham, Alabama, licensed in Alabama (43083) and active in the NPI registry since August 2011. She is enrolled in Medicare PECOS and is a graduate of Other (2011).

NPPES Registry Identity

NPI1053690099
Entity TypeIndividualFemale
Primary Taxonomy2086X0206X
Provider Legal NameLILY GUTNIKCredential: MD MPH
Location Address1808 7TH AVE S BDB515Birmingham, AL 35294-2401
Mailing Address1808 7th Ave S # Bdb515Birmingham, AL 35233-1912 · (646) 289-2524
Phone(205) 975-5477
Fax(205) 975-5971
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateAugust 9, 2011
Last NPPES UpdateDecember 29, 20232 updates tracked since enumeration
NPPES CertifiedDecember 29, 2023
✔ NPI 1053690099 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Surgical OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2086X0206X
License✔ Licensed in AL · 43083
Definition
A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research.
1808 7TH AVE S BDB515, Birmingham, AL 35294
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Alabama, Oscar Insurance Company.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

Lily Gutnik Md Mph 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 ID1355648429
PECOS Enrollment IDI20220107001494, I20220207000615
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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Partial removal of breast 19301
A partial removal of the breast, also known as a lumpectomy, involves taking out a portion of the breast tissue to eliminate concerning cells. It's typically performed when the problem area is limited in size. This procedure helps to preserve most of the breast's appearance while aiming to remove all the unhealthy cells.
17 services17 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
14 services14 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 35294 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
$161.63 typical visit price
range $52.65 – $161.63
Typical copayment $40.40 (range $13.16 – $40.40)
Most-billed visit code 99205
Established Patient
$66.08 typical visit price
range $16.56 – $131.65
Typical copayment $16.52 (range $4.14 – $32.91)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.17/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.1
Promoting Interoperability100
Improvement Activities40
Cost70.15

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 Lily Gutnik's NPI number?

The NPI number for Lily Gutnik is 1053690099. It was assigned to this individual provider in the NPPES registry on August 9, 2011.

Where is Lily Gutnik located?

Lily Gutnik practices at 1808 7th Ave S Bdb515, Birmingham, AL 35294. The listed phone number is (205) 975-5477.

What is Lily Gutnik's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Oncology, with taxonomy code 2086X0206X.

Is Lily Gutnik enrolled in Medicare?

Yes. Lily Gutnik 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 Lily Gutnik accept?

Health plans from Blue Cross and Blue Shield of Alabama and Oscar Insurance Company list Lily Gutnik 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.

When was this NPI record last updated?

The NPPES record for Lily Gutnik was last updated on December 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.