1. Home
  2. Directory
  3. Massachusetts
  4. Somerville
  5. Pediatrics
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

LILLY SU
NPI 1639864788
Pediatrics in Somerville, MA

Active since April 05, 2023
40 HOLLAND ST, SOMERVILLE, MA 02144(617) 629-6000 Get Directions Write a Review

NPPES record last updated: July 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 8, 2026, Apr 5, 2023 (2 updates tracked since 2023).

About Lilly Su NPPES

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

LILLY SU (NPI 1639864788) is an individual pediatrics provider in Somerville, Massachusetts, licensed in Massachusetts (1026735) and active in the NPI registry since April 2023. She maintains a secondary practice location in Brookline.

NPPES Registry Identity

NPI1639864788
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameLILLY SU
Location Address40 HOLLAND STSomerville, MA 02144-2705
Mailing Address75 Gardner St Apt 25Allston, MA 02134-2203 · (443) 593-8423
Phone(617) 629-6000
Sole ProprietorYes
Enumeration DateApril 5, 2023
Last NPPES UpdateJuly 8, 20262 updates tracked since enumeration
NPPES CertifiedJuly 8, 2026
✔ NPI 1639864788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MA · 1026735
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedPediatrics · Developmental - Behavioral PediatricsTaxonomy 2080P0006X · License 1026735 (MA)
40 HOLLAND ST, Somerville, MA 02144
Open in Google Maps ↗

Secondary Practice Location 1

Location 12 Brookline PlBrookline, MA 02445-7230 · Phone (617) 355-7025

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.

ELIZABETH AHLBORN NECHEV
Nurse Practitioner
40 HOLLAND ST
SOMERVILLE, MA 02144
Middlesex County (617) 657-6445
HENRY W STOLL PA
Physician Assistant (Medical)
40 HOLLAND ST
SOMERVILLE, MA 02144
Middlesex County (617) 629-6000
D. SCOTT GILBERT PA-C
Physician Assistant
40 HOLLAND ST
SOMERVILLE, MA 02144
Middlesex County (617) 654-7111
STEPHANIE E. NEALY RD, LDN
Dietitian, Registered
40 HOLLAND ST, NUTRITION
SOMERVILLE, MA 02144
Middlesex County (617) 629-6444
MARIA ELIZABETH HEDBERG FNP
Nurse Practitioner (Family)
40 HOLLAND ST
SOMERVILLE, MA 02144
Middlesex County (617) 629-6000
MRS. ANNETTE OHEARN 5532-DO-DO
Technician/Technologist (Optician)
40 HOLLAND ST
SOMERVILLE, MA 02144
Middlesex County (617) 629-6378
SHEENA ANN FREMAULT MACEDO FNP-C
Nurse Practitioner
40 HOLLAND ST
SOMERVILLE, MA 02144
Middlesex County (617) 629-6032
RICHARD MICHALOWSKI DMD
Dentist (General Practice)
40 HOLLAND ST
SOMERVILLE, MA 02144
Middlesex County (617) 629-6080

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 Lilly Su's NPI number?

The NPI number for Lilly Su is 1639864788. It was assigned to this individual provider in the NPPES registry on April 5, 2023.

Where is Lilly Su located?

Lilly Su practices at 40 Holland St, Somerville, MA 02144. The listed phone number is (617) 629-6000.

What is Lilly Su's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Lilly Su was last updated on July 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 days 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.