DR. THEODORE J LILLY M.D.
NPI 1154307932
Internal Medicine in Burleson, TX

Q: What is Theodore Lilly's NPI number?

The NPI number for Theodore Lilly is 1154307932. It was assigned to this individual provider in the NPPES registry on December 22, 2005.

Q: What is Theodore Lilly's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Theodore Lilly was last updated on September 2, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.

Active since December 22, 2005PECOS EnrolledAccepts Medicare Assignment

434 S.W. WILSHIRE, BURLESON, TX 76028(817) 447-1208(817) 447-1106 Get Directions Write a Review

NPPES record last updated: September 2, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Theodore J Lilly M.d. NPPES

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

DR. THEODORE J LILLY M.D. (NPI 1154307932) is an individual internal medicine provider in Burleson, Texas, licensed in Texas (G9146) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Medical City Arlington, and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (1982).

NPPES Registry Identity

NPI1154307932

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. THEODORE J LILLYCredential: M.D.

Location Address434 S.W. WILSHIREBurleson, TX 76028-5330

Mailing Address434 S. W. Wilshire Blvd.Burleson, TX 76028-5330 · (817) 447-1208 · Fax (817) 447-1106

Phone(817) 447-1208

Fax(817) 447-1106

Sole ProprietorNo

Medical School CMSUniversity Of Iowa, Rj & L Carver College Of MedicineGraduated 1982

Enumeration DateDecember 22, 2005

Last NPPES UpdateSeptember 2, 2008

✔ NPI 1154307932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in TX · G9146

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

434 S.W. WILSHIRE, Burleson, TX 76028

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Other Identifiers 6

Medicare UPINA02250TX

Medicare PIN00N84VTX

MedicaidP000N84V4TX

Medicare PINN84V

Other110088148Medicare Rr

Other89072STX · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, 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

Dr. Theodore J Lilly M.d. 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 ID1759458755

PECOS Enrollment IDI20080917000179

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 12

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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

297 services140 patients

Assessment of emotional or behavioral problems 96127

Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.

195 services108 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

75 services75 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

56 services55 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

52 services43 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

50 services50 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

41 services30 patients

Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a G0179

This procedure involves a doctor or approved practitioner reviewing your health status and re-certifying your need for Medicare-covered home health services. It includes communication with the home health agency and assessment of your health reports, even when you're not physically present.

29 services17 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

21 services16 patients

Administration of vaccine 90471

Administering a vaccine involves injecting a small, safe piece of a virus or bacteria into your body. This triggers your immune system to recognize and fight off the disease in the future. It's a vital tool in preventing serious illnesses and maintaining public health.

17 services17 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

13 services13 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Medical City Arlington

Acute Care Hospitals · Arlington, TX

2/5 CMS rating

OwnershipProprietary

CMS Certification Number450675

Location3301 Matlock RoadArlington, TX 76015 · Tarrant County

Emergency services Birthing friendly

Methodist Mansfield Medical Center

Acute Care Hospitals · Mansfield, TX

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number670023

Location2700 E Broad StreetMansfield, TX 76063 · Tarrant County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76028 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

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

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

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

REED CHIROPRACTIC & WELLNESS CENTER, P.C.

Chiropractor

434 S.W. WILSHIRE
BURLESON, TX 76028

Johnson County (817) 915-3129

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 Theodore Lilly's NPI number?

The NPI number for Theodore Lilly is 1154307932. It was assigned to this individual provider in the NPPES registry on December 22, 2005.

Where is Theodore Lilly located?

Theodore Lilly practices at 434 S.W. Wilshire, Burleson, TX 76028. The listed phone number is (817) 447-1208.

What is Theodore Lilly's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Theodore Lilly enrolled in Medicare?

Yes. Theodore Lilly 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 Theodore Lilly accept?

Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas and Oscar Insurance Company list Theodore Lilly 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 Theodore Lilly affiliated with any hospitals?

According to CMS data, Theodore Lilly is affiliated with Medical City Arlington and Methodist Mansfield Medical Center.

When was this NPI record last updated?

The NPPES record for Theodore Lilly was last updated on September 2, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.