Chad Ethan Tiller, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-04010 Issued in NC

Practice address

10211 Alm St
Suite 1200
Raleigh, NC 27617-8221

Phone

(919) 206-4889

Fax

(919) 206-4875

NPI assigned

Feb 10, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

University of Washington School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Duke University Affiliated Physicians, Inc.Group PAC ID 3779489588, 452 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Duke University Hospital Hospital, Durham, NC, CCN 340030

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ctiller29507@direct.medicine.duke.edu

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.

• Duke University Affiliated Physicians, Inc.

  dba Sutton Station Internal Medicine

  • Internal Medicine Physician
  • Durham, NC
  • NPI 1316975972
  Medicare reassignment Care Compare group
• Duke University Affiliated Physicians, Inc.

  dba Duke Urgent Care

  • Emergency Medicine Physician
  • Raleigh, NC
  • NPI 1710120795
  NPD
• Duke University Affiliated Physicians, Inc.

  dba Duke Urgent Care Hillsborough

  • Family Medicine Physician
  • Hillsborough, NC
  • NPI 1801338272
  NPD
• Duke University Affiliated Physicians, Inc.

  dba Duke Primary Care

  • Family Medicine Physician
  • Durham, NC
  • NPI 1225073554
  NPD (past)
• Dr. Terry D. Johnson, P.a.

  dba Forestview Primary Care

  • Family Medicine Physician
  • Moncks Corner, SC
  • NPI 1467751495
  NPD (past)
• Linda L. Johnson MD, LTD

  dba SMA Convenient Care

  • Adult Medicine Physician
  • Henderson, NV
  • NPI 1376838110
  NPD (past)

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

• Duke University Health System Inc

  dba Duke Raleigh Hospital, a campus of Duke University Hospital

  • Rehabilitation Hospital Unit
  • Raleigh, NC
  • NPI 1205225646
  Care Compare affiliation
• Duke University Health System Inc

  dba Duke Raleigh Hospital, a campus of Duke University Hospital

  • Clinical Medical Laboratory
  • Raleigh, NC
  • NPI 1306828108

  Hospital

  Care Compare affiliation
• Duke University Health System Inc

  dba Duke University Hospital

  • Clinical Medical Laboratory
  • Durham, NC
  • NPI 1508847047

  Hospital

  Care Compare affiliation
• Duke University Health System, Inc.

  dba Duke University Hospital

  • Land Ambulance
  • Durham, NC
  • NPI 1417954942

  Hospital

  Care Compare affiliation
• Duke University Health System, Inc.

  dba Duke University Hospital

  • Rehabilitation Hospital Unit
  • Durham, NC
  • NPI 1538166061
  Care Compare affiliation
• Duke University Health System, Inc.

  dba Duke University Hospital

  • General Acute Care Hospital
  • Durham, NC
  • NPI 1992703540
  Care Compare affiliation

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

{
    "created_epoch": "1265760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1033441480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751274",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751274",
            "telephone_number": "702-560-2916",
            "fax_number": "702-560-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10211 ALM ST",
            "address_2": "SUITE 1200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276178221",
            "telephone_number": "919-206-4889",
            "fax_number": "919-206-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "CHAD",
        "middle_name": "ETHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-10",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1197",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033441480",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Tiegreen, PH.D.
• Kelsie Tieman Overbey, LCSWA
• Julie Trainer Tiffany, M.D.
• Joseph Tigue, PA
• Christopher Joseph Tikvart, DDS
• Sarah Katherine Tiller, LCSW, LCAS
• Candace Tilley
• Diane S Tilley, FNP-BC
• Lyndzee Tilley, CRC, LCMHC-A
• Marilee Marshall Tilley, CRNA

• Physician Assistant in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.