Individual provider Active NPI

Mark A Till, MD

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1043253495
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G5692 Issued in TX
Practice address
8200 Walnut Hill LN
Dallas, TX 75231-4426
Phone
(214) 345-6789
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G5692 TX Primary

Addresses

Primary practice location

8200 Walnut Hill LN
Dallas, TX 75231-4426

Mailing address

PO Box 8549
Fort Worth, TX 76124-0549
Phone (817) 451-4208

Other identifiers 1

IdentifierTypeStateIssuer
0086DNOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20100405000441 TX Practitioner - Emergency Medicine 4486737293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Medicine Resources, LLP Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1043253495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8549",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761240549",
            "telephone_number": "817-451-4208",
            "fax_number": "817-563-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 WALNUT HILL LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314426",
            "telephone_number": "214-345-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILL",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G5692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0086DN",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.