LILLIAN G SHIVELY (PA-C) – Physician Assistant, NPI 1972108280
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for LILLIAN G SHIVELY (PA-C)
903 S State St
Jerseyville, IL 620522344
Phone: (618) 639-9255
Fax: (618) 639-8100
Type: Location
390 Maple Summit Rd
Illini Bldg
Jerseyville, IL 62052
Phone: (618) 498-2101
Fax: (618) 498-8153
Type: Location
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 620522000
Phone: (618) 498-7518
Fax: (618) 498-3052
Type: Mailing
270 MAPLE SUMMIT RD
MCDOW BLDG
JERSEYVILLE, IL 62052
Phone: (618) 498-7108
Fax: (618) 498-7919
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 116 Open Payments records for all available years, with a total value of $2,078.
Total Amount is formed as General ($2,078) + Research ($0) + Ownership ($0) = $2,078.
Last reported payment date: 2024-12-16 • Largest payer in this snapshot: ABBVIE INC. ($606).
Total Amount
$2,078
General + Research + Ownership
Payments
116
Total payment records
General Amount
$2,078
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $606 |
| Lilly USA, LLC | $338 |
| Amgen Inc. | $322 |
| Salix Pharmaceuticals, a division of Bausch Health US, LLC | $106 |
| Corcept Therapeutics | $78 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-01-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210121000934 | I | Physician Assistant | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62052)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| - | NY | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Cardiovascular Disease (Cardiology) | MO | |
| G A S T R O E N T E R O L O G Y | MO | |
| - | NC | |
| - | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL |
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