LILLIAS HOLMES MAGUIRE MD
NPI 1063674562
Colon & Rectal Surgery in Philadelphia, PA
Quality Rating: 79.27 out of 100 score
NPI Status: Active since June 26, 2008
Contact Information
3400 SPRUCE STREET
4TH FLOOR SILVERSTEIN
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 662-2078
Fax: (215) 615-0471
- NPI Profile Information
- Primary Taxonomy
- Secondary Taxonomies
- Insurance Plans Accepted
- Medicare Participation & PECOS Status
- Areas of Expertise
- Durable Medical Equipment
- Physician Visit Costs
- Overall Quality Performance
- Hospital Affiliations - Privileges
- NPI Validation
- Other Providers Same Location
- Frequently Asked Questions
- Individual
- Female
- Years of Experience 18
- Colon & Rectal Surgery
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About LILLIAS MAGUIRE
This page provides the complete NPI Profile along with additional information for Lillias Maguire, a provider established in Philadelphia, Pennsylvania with a medical specialization in Colon & Rectal Surgery and more than 18 years of experience. She graduated from Pennsylvania State University College Of Medicine in 2008. The healthcare provider is registered in the NPI registry with number 1063674562 assigned on June 2008. The practitioner's primary taxonomy code is 208C00000X with license number MD475304 (PA). The provider is registered as an individual and her NPI record was last updated 4 years ago.
- NPI
- 1063674562
- Provider Name
- LILLIAS HOLMES MAGUIRE MD
- Other Name
- LILLIAS C HOLMES
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 3400 SPRUCE STREET 4TH FLOOR SILVERSTEIN PHILADELPHIA, PA 19104
- Location Phone
- (215) 662-2078
- Location Fax
- (215) 615-0471
- Mailing Address
- 3400 SPRUCE STREET 4TH FLOOR SILVERSTEIN PHILADELPHIA, PA 19104
- Mailing Phone
- (215) 662-2078
- Mailing Fax
- (215) 615-0471
- Medical School Name
- PENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
- Graduation Year
- 2008
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-26-2008
- Last Update Date
- 11-02-2021
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Colon & Rectal Surgery
- Taxonomy Code
- 208C00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD475304
- License State
- PA
- Taxonomy Description
- A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | MD475304 (PA) |
2 | 208C00000X | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | 4301111770 (MI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Premier Bronze HSA - EPO
- Premier Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Lillias Maguire is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Lillias Maguire is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 8628297090
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20211213000293
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Orthotic Devices
DME-Orthotic Devices (DF010N)
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each (HCPCS:A4385)
5 DME suppliers used 12 Medicare Claims 360 Services Paid
DME-Orthotic Devices (DF010N)
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce (HCPCS:A4394)
4 DME suppliers used 14 Medicare Claims 238 Services Paid
DME-Orthotic Devices (DF010N)
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each (HCPCS:A4407)
3 DME suppliers used 18 Medicare Claims 560 Services Paid
DME-Orthotic Devices (DF010N)
Skin barrier, wipes or swabs, each (HCPCS:A5120)
3 DME suppliers used 11 Medicare Claims 575 Services Paid
Durable Medical Equipment
DME-Medical/Surgical Supplies (DA000N)
Adhesive remover, wipes, any type, each (HCPCS:A4456)
3 DME suppliers used 14 Medicare Claims 1020 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Colonoscopy
New patient office or other outpatient visit, 30-44 minutes
A colonoscopy is a medical procedure that allows your doctor to examine your colon (the large intestine). It utilizes a thin, flexible tube with a tiny camera on the end, which is inserted through the rectum. This procedure can help identify issues such as polyps, inflammation, or early signs of cancer. It's usually recommended for people over 50 or those with specific risk factors.
This service was performed for 26 patientsThis service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 17 times for 17 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $23.17 for a new patient copayment and $18.61 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 19104 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $92.69
- Minimum New Patient Price $59.88
- Maximum New Patient Price $180.99
- Average New Patient Copayment $23.17
- Minimum New Patient Copayment $14.97
- Maximum New Patient Copayment $45.24
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $74.47
- Minimum Established Patient Price $19.3
- Maximum Established Patient Price $147.29
- Average Established Patient Copayment $18.61
- Minimum Established Patient Copayment $4.82
- Maximum Established Patient Copayment $36.82
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 79.27, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 79.27 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 73.57
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: 57.35
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: 57.35
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Lillias Maguire is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
HOSPITAL OF UNIV OF PENNSYLVANIA | 34TH & SPRUCE STS PHILADELPHIA, PA 19104 | (215) 662-3227 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 0 | 6 | 3 | 6 | 7 | 4 | 5 | 6 | 2 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 0 | 12 | 3 | 12 | 7 | 8 | 5 | 12 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 0 + 1 + 2 + 3 + 1 + 2 + 7 + 8 + 5 + 1 + 2 + 24 = 58 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 58 = 2 | 2 |
The NPI number 1063674562 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1184620296 | ANNE M FOLEY CRNP Individual | Nurse Practitioner (Adult Health) | 3400 SPRUCE STREET 4 SILVERSTEIN PHILADELPHIA, PA 19104 (215) 615-4949 |
1427046564 | DINESH H JAGASIA MD Individual | Internal Medicine (Cardiovascular Disease) | 3400 SPRUCE STREET EAST PAVILION, 2ND FLOOR PHILADELPHIA, PA 19104 (215) 662-2246 |
1053373597 | MELANIE A FREAS CRNP Individual | Nurse Practitioner (Acute Care) | 3400 SPRUCE STREET 6 SILVERSTEIN PHILADELPHIA, PA 19104 (215) 662-2050 |
1821049909 | DR. TIMOTHY R DILLINGHAM MD Individual | Physical Medicine & Rehabilitation | 3400 SPRUCE STREET 1 GROUND WHITE BUILDING PHILADELPHIA, PA 19104 (215) 662-3261 |
1386697993 | BARRY R SMOGER MD Individual | Nuclear Medicine | 3400 SPRUCE STREET PHILADELPHIA, PA 19104 (215) 662-3005 |
1861449902 | CRAIG ALFRED UMSCHEID MD Individual | Internal Medicine | 3400 SPRUCE STREET PHILADELPHIA, PA 19104 (215) 662-4000 |
1811944937 | KEITH VAN ARSDALEN MD Individual | Urology | 3400 SPRUCE STREET 9 PENN TOWER PHILADELPHIA, PA 19104 (215) 662-2891 |
1487601365 | ELIZABETH M DATNER MD Individual | Emergency Medicine | 3400 SPRUCE STREET GROUND SILVERSTEIN BLDG PHILADELPHIA, PA 19104 (215) 662-6963 |
1508813445 | MARK S WEISS MD Individual | Anesthesiology | 3400 SPRUCE STREET PHILADELPHIA, PA 19104 (215) 349-8310 |
1013964832 | CURTIS W SLIPMAN MD Individual | Physical Medicine & Rehabilitation | 3400 SPRUCE STREET 1 GROUND WHITE BLDG PHILADELPHIA, PA 19104 (215) 662-3261 |
1316984511 | CHARLES M VOLLMER JR. MD Individual | Surgery | 3400 SPRUCE STREET 4 SILVERSTEIN PHILADELPHIA, PA 19104 (215) 662-2626 |
1760421267 | ANDREA T LABORDE MD Individual | Physical Medicine & Rehabilitation | 3400 SPRUCE STREET 1 GROUND WHITE BLDG PHILADELPHIA, PA 19104 (215) 662-3261 |
1003855503 | BERNADETTE C WHEELER MD Individual | Obstetrics & Gynecology | 3400 SPRUCE STREET 1 WEST GATES PHILADELPHIA, PA 19104 (215) 662-2730 |
1568402550 | JAMES L MULLEN MD Individual | Surgery | 3400 SPRUCE STREET 4 SILVERSTEIN BLDG PHILADELPHIA, PA 19104 (215) 662-2050 |
1790726164 | ANGELINA D CASTRO MD Individual | Anesthesiology | 3400 SPRUCE STREET 4 DULLES BUILDING PHILADELPHIA, PA 19104 (215) 349-8310 |
1306887781 | DIMITRY Y BARANOV MD Individual | Anesthesiology | 3400 SPRUCE STREET 4 DULLES PHILADELPHIA, PA 19104 (215) 349-8310 |
1124069067 | STANLEY JAY AUKBURG MD Individual | Anesthesiology | 3400 SPRUCE STREET 4 DULLES BUILDING PHILADELPHIA, PA 19104 (215) 349-8310 |
1487695185 | PATRICK J NELIGAN MD Individual | Anesthesiology | 3400 SPRUCE STREET 4 DULLES BUILDING PHILADELPHIA, PA 19104 (215) 349-8310 |
1447292982 | SELINA LUGER MD Individual | Internal Medicine (Hematology) | 3400 SPRUCE STREET 15 PENN TOWER PHILADELPHIA, PA 19104 (215) 662-3914 |
1841233152 | DAVID J VAUGHN MD Individual | Internal Medicine (Medical Oncology) | 3400 SPRUCE STREET 12 PENN TOWER PHILADELPHIA, PA 19104 (215) 662-3914 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063674562, enumerated in the NPI registry as an "individual" on June 26, 2008
The provider is located at 3400 Spruce Street 4th Floor Silverstein Philadelphia, Pa 19104 and the phone number is (215) 662-2078
The provider's speciality is Colon & Rectal Surgery with taxonomy code 208C00000X
The provider has more than 18 years of experience. She graduated from Pennsylvania State University College Of Medicine in 2008.
The provider might be accepting Accepts: Ambetter Health and Ambetter Health of Delaware. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $92.69 with an average copayment of $23.17 for new patient appointments. Established patients should expect a typical charge of $74.47 and an average copayment of 18.61. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Colonoscopy and New patient office or other outpatient visit, 30-44 minutes.
The practitioner is affiliated to the following hospital(s): HOSPITAL OF UNIV OF PENNSYLVANIA. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on June 26, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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