LILY ANN HEROUT PA
NPI 1295303295
Physician Assistant in Saratoga Springs, NY

Q: What is Lily Herout's NPI number?

The NPI number for Lily Herout is 1295303295. It was assigned to this individual provider in the NPPES registry on June 15, 2021.

Q: What is Lily Herout's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Lily Herout was last updated on June 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 June 15, 2021PECOS EnrolledAccepts Medicare Assignment

65.44/100

CMS Quality Rating

211 CHURCH ST, SARATOGA SPRINGS, NY 12866(518) 587-3222 Get Directions Write a Review

NPPES record last updated: June 15, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Lily Ann Herout Pa NPPES

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

LILY ANN HEROUT PA (NPI 1295303295) is an individual physician assistant in Saratoga Springs, New York and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS, is affiliated with Saratoga Hospital, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1295303295

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameLILY ANN HEROUTCredential: PA

Location Address211 CHURCH STSaratoga Springs, NY 12866-1090

Mailing Address18675 W Edwards RdAntioch, IL 60002-7231 · (847) 323-8344

Phone(518) 587-3222

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJune 15, 2021

NPPES CertifiedJune 15, 2021

✔ NPI 1295303295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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.

211 CHURCH ST, Saratoga Springs, NY 12866

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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 Ann Herout 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 ID1254736374

PECOS Enrollment IDI20210826002665

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 4

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.

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

71 services70 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

69 services68 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.

67 services67 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.

58 services58 patients

Hospital Affiliations CMS Care Compare

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

Saratoga Hospital

Acute Care Hospitals · Saratoga Springs, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330222

Location211 Church StreetSaratoga Springs, NY 12866 · Saratoga County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12866 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.57 typical visit price

range $17.54 – $136.14

Typical copayment $17.14 (range $4.38 – $34.03)

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.

65.44/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

56.37

Improvement Activities

Cost

64.8

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.

ROBERT I GOGUEN

Counselor (Mental Health)

211 CHURCH ST, CRAMER HOUSE
SARATOGA SPRINGS, NY 12866

Saratoga County (518) 584-9030

JEAN R MISCHLER NP

Nurse Practitioner