Tracy Tiller, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35052697T Issued in OH

Practice address

10400 New Haven Rd
Harrison, OH 45030-1657

Phone

(513) 367-5888

Fax

(513) 367-1015

NPI assigned

Jun 20, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children'S Hospital Medical Center

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1609915784
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237161600000",
    "number": "1013952142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 AUBURN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192701",
            "telephone_number": "513-221-4949",
            "fax_number": "513-221-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 NEW HAVEN RD",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450301657",
            "telephone_number": "513-367-5888",
            "fax_number": "513-367-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "TRACY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2009-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35052697T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0597911",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Teets
• Keith Peter Tenhundfeld, FNP-BC
• The Little Clinic of Ohio LLC
• Thoma & Sutton Eyecare Professionals, LLC
• Thomas J Madl Jr DMD, LLC
• Jenna L Townsley, CDCA
• Robert Trapp III, RPH
• Trihealth Q, LLC
• Trilogy Healthcare of Hamilton III, LLC
• Tanh Truong, PHARMD

• Pediatrics Physician in Harrison, OH
• Providers in Harrison, OH by specialty
• Pediatrics Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.