Individual provider Active NPI

Elizabeth Clemow-Tilley, ARNP

  • Adult Health Nurse Practitioner
  • Stuart, FL
National Provider Identifier
1053372045
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2784382 Issued in FL
Practice address
1713 NW Federal Hwy
Stuart, FL 34994-9631
Phone
(772) 324-5400
Fax
(772) 934-6342
NPI assigned
Mar 29, 2006
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN2784382 FL Primary

Addresses

Primary practice location

1713 NW Federal Hwy
Stuart, FL 34994-9631

Mailing address

991 Mohawk St
Jupiter, FL 33458-5642
Phone (561) 401-5159

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100626000061 FL Practitioner - Nurse Practitioner 5890826424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dbhmdmedicine P aGroup PAC ID 1254631427, 2 clinicians

Practice addresses (Care Compare)

1713Nwfederal Hwy
Stuart, FL 34994-9631
Phone (772) 324-5400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2784382FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dbhmdmedicine P a CurrentSince Oct 1, 2015 Accepting new patients
Cardiopulmonary Associates of the Treasure Coast PA Past Accepting new patients

Locations

1713 NW Federal Hwy
Stuart, FL 34994
Phone (772) 324-5400

Interoperability endpoints

  • Direct secure messaging: elizabeth.clemow-tilly.1@12611.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/12611/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 1

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1053372045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 MOHAWK ST",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585642",
            "telephone_number": "561-401-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 NW FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349949631",
            "telephone_number": "772-324-5400",
            "fax_number": "772-934-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMOW-TILLEY",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "RN2784382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.