Active NPI 1154307932 Individual Practitioner Male Practitioner

Dr. Theodore J Lilly , MD

Internal Medicine • Burleson, TX

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Theodore Lilly, MD is a certified Internal Medicine practicing in Burleson, TX. With approximately 44 years of clinical experience since graduating from University Of Iowa, Rj & L Carver College Of Medicine in 1982, Dr. Lilly delivers high-quality medical care to the local community at 434 S.W. WILSHIRE.

Dr. Lilly is affiliated with Questcare Medical Clinics Pllc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, assessment of emotional or behavioral problems, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

434 S.w. Wilshire

Burleson, TX 760285330

Telephone 8174471208

Fax 8174471106

Associated Practice Facility / Clinic

🏢 Reed Chiropractic & Wellness Center, P.c. Facility NPI 1538283734

Medicare Profile & Education

Medical School

University Of Iowa, Rj & L Carver College Of Medicine

Graduation Year

1982

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Burleson, TX

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

44 Yrs +22.6 yrs vs City Avg

City Avg: 21.4 Yrs

State Avg: 26.2 Yrs

Regional Practice Density

39 Specialists

Practicing in Burleson, TX (9538 Statewide)

Telehealth Adoption Rate

17.9% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

63.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lilly (44 Years) 44 Yrs

Burleson Specialty Average (21.4 Years) 21.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	297	140	$585.00	$172.74
96127 Assessment of emotional or behavioral problems	195	108	$16.00	$4.33
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	75	75	$470.00	$123.52
G0008 Administration of influenza virus vaccine	56	55	$89.00	$31.03
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or	52	43	$79.00	$31.10
90653 Vaccine for influenza for injection into muscle	50	50	$52.00	$50.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	41	30	$435.00	$122.33
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	29	17	$167.00	$39.68
83036 Hemoglobin A1C level	21	16	$46.00	$9.52
90471 Administration of 1 vaccine	17	17	$89.00	$19.51
G0009 Administration of pneumococcal vaccine	13	13	$89.00	$31.03
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	12	12	$425.58	$289.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	220	126	$585.00	$171.96
96127 Assessment of emotional or behavioral problems	158	98	$16.00	$4.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	132	97	$435.00	$123.01
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	109	109	$470.00	$123.58
G0008 Administration of influenza virus vaccine	56	56	$89.00	$30.27
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	47	47	$105.00	$75.46
G0009 Administration of pneumococcal vaccine	37	37	$89.00	$30.24
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	23	23	$425.58	$282.68
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	20	20	$259.00	$130.80
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	20	14	$167.00	$39.46
83036 Hemoglobin A1C level	15	12	$46.00	$9.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	261	157	$435.00	$123.30
96127 Assessment of emotional or behavioral problems	141	101	$16.00	$4.44
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	133	93	$585.00	$173.75
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	58	58	$470.00	$126.15
G0008 Administration of influenza virus vaccine	38	37	$89.00	$29.23
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	36	36	$105.00	$70.25
99457 Management using the results of remote vital sign monitoring per calendar month, first 20 minutes	27	11	$117.00	$48.32
G0009 Administration of pneumococcal vaccine	18	18	$89.00	$29.39
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	18	14	$167.00	$39.41
83036 Hemoglobin A1C level	18	15	$46.00	$9.59
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	12	12	$259.00	$131.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	308	164	$435.00	$126.30
96127 Assessment of emotional or behavioral problems	185	105	$15.91	$4.52
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	161	92	$585.00	$176.62
99457 Management using the results of remote vital sign monitoring per calendar month, first 20 minutes	63	15	$117.00	$49.09
99454 Remote monitoring of physiologic parameters, initial supply of devices with daily recordings or programmed alerts transmission, each 30 days	60	15	$146.00	$60.19
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	39	39	$470.00	$128.96
99458 Remote physiologic monitoring treatment management services, health care professional time in a calendar month requiring interactive communication with the patient/caregiver; each additional 20 minute	33	13	$95.00	$39.76
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	33	18	$167.00	$39.84
G0008 Administration of influenza virus vaccine	29	28	$89.00	$16.96
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	26	26	$105.00	$66.43
83036 Hemoglobin A1C level	22	16	$46.00	$9.71
G0009 Administration of pneumococcal vaccine	19	19	$89.00	$16.84
90670 Pneumococcal vaccine for injection into muscle	12	12	$338.00	$236.70
99453 Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment	11	11	$45.00	$18.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	439	187	$435.00	$105.33
96127 Assessment of emotional or behavioral problems	114	93	$16.00	$4.65
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	43	43	$470.00	$113.06
90662 Influenza vaccine split virus, preservative free	41	39	$105.00	$60.09
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	37	33	$585.00	$139.72
G0008 Administration of influenza virus vaccine	29	27	$89.00	$16.61
G0009 Administration of pneumococcal vaccine	29	28	$89.00	$16.62
90670 Pneumococcal vaccine for injection into muscle	19	19	$338.00	$223.88
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$662.00	$160.85
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	17	13	$89.00	$13.74
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	16	12	$167.00	$39.59
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	11	11	$259.00	$117.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	507	194	$584.20	$140.11
G0008 Administration of influenza virus vaccine	44	44	$86.98	$15.54
90662 Influenza vaccine split virus, preservative free	40	40	$103.88	$54.63
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	32	21	$167.00	$39.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	23	21	$435.00	$104.65
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	23	23	$833.00	$199.62
G0009 Administration of pneumococcal vaccine	16	16	$89.00	$15.90
90670 Pneumococcal vaccine for injection into muscle	13	13	$338.00	$209.48
36415 Insertion of needle into vein for collection of blood sample	11	11	$13.00	$2.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	423	165	$435.00	$100.77
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	124	94	$585.00	$136.02
90662 Influenza vaccine split virus, preservative free	59	58	$105.00	$52.16
G0008 Administration of influenza virus vaccine	57	56	$89.00	$19.51
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	28	18	$167.00	$38.87
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$662.00	$154.77
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	23	11	$89.00	$19.03
G0009 Administration of pneumococcal vaccine	14	14	$89.00	$19.51

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	106	89	$435.00	$99.69
G0008 Administration of influenza virus vaccine	43	43	$89.00	$23.91
90662 Influenza vaccine split virus, preservative free	38	38	$105.00	$48.05
G0009 Administration of pneumococcal vaccine	13	13	$89.00	$23.91

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License TX G9146

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

P000N84V4 (TX)

Commercial Insurance / Payer ID Medicare Rr

110088148

Commercial Insurance / Payer ID Bcbs

89072S (TX)

Hospital & Practice Group Affiliations

Questcare Medical Clinics Pllc

8861 Davis Blvd, Keller, TX 762480306

Phone: 9549395000

Questcare Medical Clinics Pllc

1001 Matlock Rd, Mansfield, TX 760636564

Phone: 9549395000

Questcare Medical Clinics Pllc

1571 Sw Wilshire Blvd, Burleson, TX 760288717

Phone: 9549395000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Dr. Burlyn Nelon , DO

Family Medicine

NPI 1184600397

Doctor of Osteopathic Medicine (D.O.)

Nicole Stell , FNP-C

Nurse Practitioner - Family

NPI 1841738234

Family Nurse Practitioner (Certified)

Courtney Martinez , FNP

Nurse Practitioner

NPI 1982180139

Family Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active September 02, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location September 02, 2008

Registered at 434 S.W. WILSHIRE, BURLESON, TX 760285330 (Tel: 8174471208)

📍

Updated Business Mailing Address September 02, 2008

Registered at 434 S. W. WILSHIRE BLVD., BURLESON, TX 760285330 (Tel: 8174471208)

👤

Provider Name / Credentials Updated September 02, 2008

Recorded as THEODORE LILLY, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 02, 2008

Internal Medicine (License #G9146 in TX)

🟢

Initial NPI Registration & Enumeration December 22, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154307932

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 22, 2005

Last Update: September 02, 2008

Sole Proprietor: No

Update or Correct Profile

Mailing Address

434 S. W. Wilshire Blvd.

Burleson, TX 760285330

Phone: 8174471208

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.