NPIMap

Individual provider Active NPI

Timothy Pilla, M.D.

  • Vascular Surgery Physician
  • Woodbury, NJ
National Provider Identifier
1023019312
Registry record updated Feb 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
25MA05024600 Issued in NJ
Practice address
17 W Red Bank Ave
Suite 203
Woodbury, NJ 08096-1630
Phone
(856) 848-8242
Fax
(856) 384-6015
NPI assigned
Aug 9, 2005
Last updated
Feb 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA05024600 NJ
Vascular Surgery Physician 2086S0129X 25MA05024600 NJ Primary

Addresses

Primary practice location

17 W Red Bank Ave
Suite 203
Woodbury, NJ 08096-1630

Mailing address

2 Eves Dr
Suite 109
Marlton, NJ 08053-3193
Phone (856) 669-6061

Other identifiers 1

IdentifierTypeStateIssuer
2204207MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040423001124 NJ Practitioner - Vascular SurgeryPractitioner - General Surgery 8426044421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Jefferson Medical College of Thomas Jefferson University, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

698 Mullica Hill Rd
Suite 320
Mullica Hill, NJ 08062-4453
Phone (856) 508-3708

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion20
Colonoscopy1-10
Hernia repair - groin (open)20
Pacemaker insertion or repair1-10
Laminectomy or laminotomy (partial removal of spine bones)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Leg revascularization (restoring blood flow)58
Removal of tissue12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA05024600NJMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inspira Health Network Medical Group, P.C. CurrentSince Jan 1, 2014 Accepting new patients

Locations

1120 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 205-7071

525 Route 73 S
Ste 305A
Marlton, NJ 08053
Phone (609) 267-7050

698 Mullica Hill Rd
Ste 320
Mullica Hill, NJ 08062
Phone (856) 508-3706

798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161

17 W Red Bank Ave
Ste 104
Woodbury, NJ 08096
Phone (856) 848-0665

17 W Red Bank Ave
Ste 203
Woodbury, NJ 08096
Phone (856) 845-1818

Organizations & group practices 3

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518652800000",
    "number": "1023019312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EVES DR",
            "address_2": "SUITE 109",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533193",
            "telephone_number": "856-669-6061",
            "fax_number": "856-651-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W RED BANK AVE",
            "address_2": "SUITE 203",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961630",
            "telephone_number": "856-848-8242",
            "fax_number": "856-384-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLA",
        "first_name": "TIMOTHY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2018-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA05024600",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA05024600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2204207",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.