DR. KIRTHI KONDA LILLEY (M.D.) – Gastroenterology Physician, NPI 1063733111
Gastroenterology Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
448 GASTROENTEROLOGY in IN
Provider Addresses for DR. KIRTHI KONDA LILLEY (M.D.)
11104 Parkview Circle Dr Ste 310
Fort Wayne, IN 468451733
Phone: (260) 266-5230
Fax: (260) 458-5972
Type: Location
3990 JOHN R ST
DETROIT, MI 482012018
Phone:
Type: Mailing
4646 JOHN R ST
11M-GAS
DETROIT, MI 482011916
Phone: (313) 576-1000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2025-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20190102000718 | I | Gastroenterology | MI | TBD |
| I20250930000485 | I | Gastroenterology | IN | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 15 | 15 | $0 |
Insurance plans in this area (ZIP 46845)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| G A S T R O E N T E R O L O G Y | MI | |
| P A T H O L O G Y | MI | |
| Gastroenterology, Internal Medicine | MI | |
| G A S T R O E N T E R O L O G Y | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| Gastroenterology, Internal Medicine | MI | |
| G A S T R O E N T E R O L O G Y | MI | |
| Nurse Practitioner | MI | |
| G A S T R O E N T E R O L O G Y | MI |
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