KEVIN DOUGLAS LILLE (PAC) – Physician Assistant, NPI 1679588750

KEVIN DOUGLAS LILLE (PAC) is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. PA9101308 (FL). The NPI Number for KEVIN DOUGLAS LILLE (PAC) is 1679588750

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN DOUGLAS LILLE (PAC)
NPI
1679588750
Phone
(405) 607-1318
Address
3141 NW 63RD
Enumeration Date
29 July 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9412052180
Graduation Year
2000 (26 years ago)
PAC ID
4789575218
Group Practice PAC ID
7214053727
Professional Enrollment ID
I20040323001239
Address ID
FL339504828PU324XXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

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Provider Addresses for KEVIN DOUGLAS LILLE (PAC)

  • Northeast 63rd Street, Oklahoma City, Oklahoma County, Oklahoma, 73132, United States

    SUITE 4

    OKLAHOMA CITY, OK 73116

    Phone: (405) 607-1318

    Fax: (405) 607-1326

    Type: Mailing

  • Fawcett Memorial Hospital, 21298, Olean Boulevard, Port Charlotte, Charlotte County, Florida, 33952, United States

    FAWCETT MEMORIAL HOSPITAL

    PORT CHARLOTTE, FL 33952

    Phone: (941) 627-6130

    Fax: (941) 627-6146

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $83.

Total Amount is formed as General ($83) + Research ($0) + Ownership ($0) = $83.

Last reported payment date: 2023-01-31 • Largest payer in this snapshot: Medtronic, Inc. ($83).

Total Amount

$83

General + Research + Ownership

Payments

1

Total payment records

General Amount

$83

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-01-31

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Medtronic, Inc.$83
View all Open Payments →|Open Payments Risk Radar →

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: 2004-03-23

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040323001239IPhysician AssistantFLTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg22440$0
99284Emergency department visit with moderate level of medical decision making185184$0
99285Emergency department visit with high level of medical decision making143138$0
99203New patient office or other outpatient visit, 30-44 minutes142142$0
99213Established patient office or other outpatient visit, 20-29 minutes6747$0
View full utilization report →

Insurance plans in this area (ZIP 73116)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7214053727View full group profile
NameSpecialtyState
C H I R O P R A C T I CPA
-MO
C H I R O P R A C T I CMI
C H I R O P R A C T I CFL
C H I R O P R A C T I CFL

Reviews

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Frequently asked questions

Does KEVIN DOUGLAS LILLE (PAC) have a public NPI I can cite?
Public records show KEVIN DOUGLAS LILLE (PAC) under NPI 1679588750.
Should I treat KEVIN DOUGLAS LILLE (PAC) as an active provider?
Patients and plans typically see KEVIN DOUGLAS LILLE (PAC) as active in the national extract.
Which specialty label fits KEVIN DOUGLAS LILLE (PAC)?
NPPES ties KEVIN DOUGLAS LILLE (PAC) to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit KEVIN DOUGLAS LILLE (PAC) in Oklahoma City, Oklahoma?
For routing, start with Oklahoma City, Oklahoma for KEVIN DOUGLAS LILLE (PAC), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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