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LILI KAPLAN MD
NPI 1518017276
Ophthalmology - Retina Specialist in King Of Prussia, PA

Active since January 12, 2007PECOS EnrolledAccepts Medicare Assignment
1013 W 9TH AVE STE A, KING OF PRUSSIA, PA 19406(215) 699-7600(215) 699-8867 Get Directions Write a Review

NPPES record last updated: April 30, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 30, 2024, Jul 21, 2022, Aug 1, 2017 (3 updates tracked since 2017).

About Lili Kaplan Md NPPES

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

LILI KAPLAN MD (NPI 1518017276) is an individual retina specialist in King Of Prussia, Pennsylvania, licensed in Pennsylvania (MD442120) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Perelman School Of Med At The University Of Pennsylvania (2006).

NPPES Registry Identity

NPI1518017276
Entity TypeIndividualFemale
Primary Taxonomy207WX0107X
Provider Legal NameLILI KAPLANCredential: MD
Location Address1013 W 9TH AVE STE AKing Of Prussia, PA 19406-1208
Mailing Address1013 W 9th Ave Ste AKing Of Prussia, PA 19406-1208 · (215) 699-7600 · Fax (215) 699-8867
Phone(215) 699-7600
Fax(215) 699-8867
Sole ProprietorNo
Medical School CMSPerelman School Of Med At The University Of PennsylvaniaGraduated 2006
Enumeration DateJanuary 12, 2007
Last NPPES UpdateApril 30, 20243 updates tracked since enumeration
NPPES CertifiedApril 30, 2024
✔ NPI 1518017276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmology · Retina SpecialistAllopathic & Osteopathic Physicians
Taxonomy Code207WX0107X
License✔ Licensed in PA · MD442120
Definition
An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
Also ListedOphthalmologyTaxonomy 207W00000X · License 0101246969 (VA), 35-125008 (OH)
1013 W 9TH AVE STE A, King Of Prussia, PA 19406
Open in Google Maps ↗

Secondary Practice Locations 2

Location 12150 Harrisburg Pike Ste 370Lancaster, PA 17601-2644 · Phone (717) 399-8790 · Fax (717) 399-3279
Location 2124 Dekalb Pike Ste 1North Wales, PA 19454-1853 · Phone (215) 699-7600 · Fax (215) 699-8867

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lili Kaplan Md 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 ID6103957006
PECOS Enrollment IDI20110829000549
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Lili Kaplan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Retina Associates Of Greater Phila., Ltd
12 mi
Ophthalmology
124 DEKALB PIKE
North Wales, PA 19454
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 2 clinicians in this Medicare group
NPI 1336181601 (215) 699-7600
Refocus Eye Health Of PA, P.C.
21 mi
Ophthalmology
3110 GRANT AVE
Philadelphia, PA 19114
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: Refocus Eye Health Of PA PC
  • 17 clinicians in this Medicare group
NPI 1962003418 (215) 288-5000
Lancaster Retina Specialists PC
50 mi
Ophthalmology
2150 HARRISBURG PIKE, SUITE 370
Lancaster, PA 17601
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 5 clinicians in this Medicare group
NPI 1558785725 (717) 399-8790

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Injection, faricimab-svoa, 0.1 mg J2777
Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.
12,001 services62 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
1,394 services447 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
1,147 services263 patients
Injection, aflibercept, 1 mg J0178
Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.
628 services78 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.
611 services441 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.
581 services216 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19406 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
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.

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 Lili Kaplan's NPI number?

The NPI number for Lili Kaplan is 1518017276. It was assigned to this individual provider in the NPPES registry on January 12, 2007.

Where is Lili Kaplan located?

Lili Kaplan practices at 1013 W 9th Ave Ste A, King Of Prussia, PA 19406. The listed phone number is (215) 699-7600.

What is Lili Kaplan's specialty?

The primary specialty registered for this NPI is Ophthalmology, specializing in Retina Specialist, with taxonomy code 207WX0107X.

Is Lili Kaplan enrolled in Medicare?

Yes. Lili Kaplan 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.

Which organizations bill Medicare for Lili Kaplan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lili Kaplan reassigns Medicare benefits to 3 organizations: Retina Associates Of Greater Phila., Ltd (North Wales, PA), Refocus Eye Health Of PA, P.C. (Philadelphia, PA) and Lancaster Retina Specialists PC (Lancaster, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lili Kaplan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lili Kaplan accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Lili Kaplan 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 Lili Kaplan was last updated on April 30, 2024. 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.