2026 NPPES data Family Medicine Physician NPI 1528051711 MD
Verify on CMS →

JOHN LILLY, MD

Family Medicine Physician in HYATTSVILLE, Maryland. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
180
Medicare Part D claims · 50 beneficiaries · Family Medicine Physician avg: 3K
Generic prescribing
83%
generic claims · 17% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
96.2015/100
▲ 13 pts above national avg 83.1 · [object Object]
Industry payments
$18
1 payments · CMS Open Payments (Sunshine Act)

What the federal data shows

JOHN LILLY, MD reported a CMS MIPS final score of 96.2015/100 — above the 83.1 national average — and filed 180 Medicare Part D claims in 2023.

96.2015/100
MIPS score · +13 vs avg
180
Part D claims, 2023
83%
generic prescribing
Likely
board-certified (heuristic)

Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) — no proprietary rating or editorial opinion is applied.

JOHN LILLY, MD's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

96 Top 17% higher than 83% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Board certification likely (heuristic — not verified)

JOHN LILLY, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

What does the federal data show about JOHN LILLY, MD?

High performer (top quartile)

NPI registry status

Active

Issued 08/24/2005

NPI 1528051711

Primary specialty

Family Medicine Physician

High-volume

147,640 US NPIs in this specialty

Medicare Part D claims

180 95% vs specialty avg

2023 prescription claims

Specialty avg: 3,418

MIPS final score

96.2015/100 13.101500000000001% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Maryland

How Family Medicine Physician compares to other specialties among Maryland providers

Maryland providers

Family Medicine Physician share within Maryland

1. Family Medicine Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Family Medicine Physician share within Maryland

Medicare quality performance — MIPS

JOHN LILLY, MD's 2023 MIPS final score plotted against the Family Medicine Physician national average

High performer (top quartile)
MIPS Final Score
96.2015/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Family Medicine Physician) — 96.2015/100 vs national avg 83.1

0%100%National avg83%96.2%
MIPS final score (Family Medicine Physician) — 96.2015/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

JOHN LILLY, MD appears in the CMS NPPES registry as a Family Medicine Physician provider holding MD credentials at 5804 BALTIMORE AVE, HYATTSVILLE, MD, 20781, with a listed phone of (301) 927-7800. NPI 1528051711 was issued on 08/24/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what LILLY most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 180 prescription claims written by this provider, covering 50 Medicare beneficiaries and totaling roughly $40K in drug spend, split 17% brand-name and 83% generic by claim count. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 96.2015/100 for the 2023 performance year (Quality 100, Cost 70.6717), compared with the national average of 83.1.

Family Medicine Physician is a high-volume specialty nationwide, with 147,640 enrolled providers across 56 states and an average of 3,418 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

5804 BALTIMORE AVE
HYATTSVILLE, MD 20781

Provider Details

NPI 1528051711
Specialty Family Medicine Physician
Credentials MD
Gender Male
NPI Issued 08/24/2005

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

96.2015
Final Score
Avg: 83.1
100
Quality
70.6717
Cost

Reporting: Group practice

Industry payments received (2024) — CMS Open Payments transparency data

The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for JOHN LILLY, MD. Source: openpaymentsdata.cms.gov.

Total received

$18

Largest payer

Boston Scientific Corporation

Most common payment type

Food and Beverage

Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.

Brand vs generic prescribing mix · Typical

JOHN LILLY, MD — brand share 17.0%
Specialty average (est.)

17% brand-name claims vs 83% generic, on 180 2023 Medicare Part D claims.

The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

180
Total Claims
$40K
Total Drug Cost
50
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
289
Total Day Supply
8,514
Brand vs Generic
17% brand / 83% generic
Brand Drug Cost
$37K
Generic Drug Cost
$3K

Patient Demographics

Average Patient Age
67.8 years
Avg HCC Risk Score
1.00
Gender Split
70% female / 30% male

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

What JOHN LILLY, MD prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Atorvastatin Calcium
15
Oxybutynin Chloride Er
Oxybutynin Chloride
12
Xarelto
Rivaroxaban
12
Nitroglycerin Patch
Nitroglycerin
11

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Family Medicine Physician Overview

How JOHN LILLY, MD fits within the Family Medicine Physician landscape nationally.

147,640
Family Medicine Physician Providers in US
56
States with Family Medicine Physician
3,418
Avg Claims per Provider

JOHN LILLY, MD's 180 claims are below the specialty average of 3,418.

Nearby Family Medicine Physician Providers in Maryland

Other clinicians with the same primary specialty enrolled in Maryland, drawn from the same CMS NPPES roster as LILLY.

Compare Family Medicine Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is JOHN LILLY, MD's specialty?
JOHN LILLY, MD specializes in Family Medicine Physician and practices in HYATTSVILLE, Maryland. Credentials: MD.
How much does JOHN LILLY, MD prescribe under Medicare Part D?
In 2023, JOHN LILLY, MD wrote 180 Medicare Part D claims totaling $40K in drug costs for 50 beneficiaries.
What is JOHN LILLY, MD's Medicare quality score?
JOHN LILLY, MD has a CMS MIPS Final Score of 96.2015/100 (Quality: 100, Cost: 70.6717). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is JOHN LILLY, MD located?
JOHN LILLY, MD is located at 5804 BALTIMORE AVE, HYATTSVILLE, MD, 20781. Phone: (301) 927-7800.
What is JOHN LILLY, MD's NPI number?
JOHN LILLY, MD's National Provider Identifier (NPI) is 1528051711, issued on 08/24/2005.
Does JOHN LILLY, MD prescribe more brand-name or generic drugs?
JOHN LILLY, MD's prescribing is 17% brand-name and 83% generic drugs by claim count, with $37K in brand drug costs.
How many Family Medicine Physician providers are there in the US?
There are 147,640 Family Medicine Physician providers across 56 states in the US. The average Family Medicine Physician provider writes 3,418 Medicare Part D claims per year.
What drugs does JOHN LILLY, MD prescribe most often?
Based on 2023 Medicare Part D data, JOHN LILLY, MD's most frequently prescribed drugs include Atorvastatin Calcium, Oxybutynin Chloride Er, Xarelto. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does JOHN LILLY, MD accept Medicare?
JOHN LILLY, MD appears in CMS Medicare data with 180 Part D claims and 50 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify JOHN LILLY, MD's credentials?
JOHN LILLY, MD's NPI is 1528051711 with credentials MD. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology