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Lilly Su

Pediatrics β€’ Somerville, MA

Active NPI 1639864788 Individual Practitioner Female Practitioner
Practice location in NPPES

40 Holland St
Somerville, MA 021442705

Call 6176296000 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

40 Holland St

Somerville, MA 021442705

Telephone 6176296000
Organization at the Same NPPES Address or Phone
Harvard Vanguard Medical Associates Facility NPI 1881756419

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Brookline, MA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Somerville and Massachusetts

25 active clinicians are listed under Pediatrics with a practice address in Somerville, MA (2,628 in Massachusetts).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Somerville

0% of these 25 clinicians have the CMS telehealth indicator.

0% of these 25 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-07-08
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES MA 1026735

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics - Developmental - Behavioral Pediatrics

NUCC Taxonomy Code: 2080P0006X

License # reported to NPPES MA 1026735

A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Massachusetts Board of Registration in Medicine.
Look Up on State Board Site

Secondary Practice Locations

2 Brookline Pl

Brookline, MA 024457230

Phone: 6173557025

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

13 listed
Cheryl Boland , NP

Nurse Practitioner - Adult Health

NPI 1528037132

Nurse Practitioner

Dr. Elisa Choi , MD

Internal Medicine

NPI 1942268362

Doctor of Medicine (M.D.)

Mackenzie Donohoe , RN

Nurse Practitioner - Adult Health

NPI 1669175048

Registered Nurse

James Gillan , PT

Physical Therapist

NPI 1679072607

Physical Therapist

NPI 1144272659

Doctor of Medicine (M.D.)

Maria Hedberg , FNP

Nurse Practitioner - Family

NPI 1043644883

Family Nurse Practitioner

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location July 08, 2026

Registered at 40 HOLLAND ST, SOMERVILLE, MA 021442705 (Tel: 6176296000)

πŸ“
Updated Business Mailing Address July 08, 2026

Registered at 75 GARDNER ST APT 25, ALLSTON, MA 021342203 (Tel: 4435938423)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2026

Pediatrics (license number reported to NPPES: MA 1026735)

βœ…
NPI Profile Active April 05, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 05, 2023

Registered at 725 WELCH RD, PALO ALTO, CA 943041601 (Tel: 6504978979)

πŸ“
Business Mailing Address (Initial Record) April 05, 2023

Registered at 36 UNIVERSITY MNR E, HERSHEY, PA 170332805 (Tel: 4435938423)

πŸ‘€
Provider Name / Credentials (Initial Record) April 05, 2023

Recorded as LILLY SU

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 05, 2023

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration April 05, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1639864788
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 05, 2023
Last Update: July 08, 2026
Sole Proprietor: Yes

Mailing Address

75 Gardner St Apt 25

Allston, MA 021342203

Phone: 4435938423

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.