Charles Patrick Tilley, NP

Primary specialty

Inpatient HospiceTaxonomy code 315D00000X

License

305286 Issued in NY

Practice address

1250 Broadway
7TH Floor
New York, NY 10001-3701

Phone

(917) 763-8716

NPI assigned

Dec 1, 2009

Sex

Male

Sole proprietor

Yes

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Calvary Hospital Inc

  • Special Hospital
  • Bronx, NY
  • NPI 1003858390
  Medicare reassignment NPD
• Calvary Hospital Inc

  • Long Term Care Hospital
  • Bronx, NY
  • NPI 1528495306
  NPD
• MJHC Home Care, Inc.

  • Home Health Agency
  • Brooklyn, NY
  • NPI 1710149984
  NPD (past)
• MJHS Hospice and Palliative Care Inc.

  • Community Based Hospice Care Agency
  • New York, NY
  • NPI 1770669038
  NPD (past)

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1023346186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 BROADWAY",
            "address_2": "7TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013701",
            "telephone_number": "917-763-8716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BROADWAY",
            "address_2": "7TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100013701",
            "telephone_number": "917-763-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "CHARLES",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-01",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "NY",
            "license": "305286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03487405",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Till, PT, DPT, OCS
• Haley Tillage
• Courtney Tillem, MS, CCC-SLP
• Ann Tilley, MD
• Ashley Nicole Tilley
• Christian Robert Tilley, MD
• Elizabeth Tillinghast, M.D.
• Jessica Tillis
• Laura Tillman, MS, OTR/L
• Sariah Rose Tillotson, MSW

• Inpatient Hospice in New York, NY
• Providers in New York, NY by specialty
• Inpatient Hospice in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.