Individual provider Active NPI

Heather Dawn Tiller, M.D.

  • Emergency Medicine Physician
  • Madison, WI
National Provider Identifier
1053501775
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
54123 Issued in WI
Practice address
1504 Edgehill Dr
Madison, WI 53705-1449
Phone
(414) 333-1238
NPI assigned
Jul 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 045567 CT
Emergency Medicine Physician 207P00000X 248348 NY
Emergency Medicine Physician 207P00000X 54123 WI Primary

Addresses

Primary practice location

1504 Edgehill Dr
Madison, WI 53705-1449

Mailing address

1504 Edgehill Dr
Madison, WI 53705-1449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100623000985 WI Practitioner - Emergency Medicine 6901991306 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.19 of 100Reported as group
Quality
74.01
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
248348NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Upland Hills Health, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Reedsburg Area Medical Center Inc CurrentSince Mar 1, 2017 Accepting new patients
Reedsburg Area Medical Center, Inc. CurrentSince Mar 1, 2017 Accepting new patients
Prairie Ridge Health Inc. CurrentSince Nov 1, 2025 Accepting new patients
Prairie Ridge Health, Inc. CurrentSince Nov 1, 2025 Accepting new patients
Upland Hills Health, Inc Emergency Medicine CurrentSince Dec 1, 2025 Accepting new patients
Reedsburg Area Medical Center, Inc. Current Accepting new patients

Locations

707 14th St
Baraboo, WI 53913
Phone (608) 356-1400

1515 Park Ave
Columbus, WI 53925
Phone (920) 623-1200

800 Compassion Way
Dodgeville, WI 53533
Phone (608) 930-7200

3400 E Racine St
Janesville, WI 53546
Phone (608) 373-8000

2000 N Dewey Ave
Reedsburg, WI 53959
Phone (608) 524-6487

Interoperability endpoints

  • Direct secure messaging: htiller263726@direct-ehr-ssmhc.com

Organizations & group practices 10

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1053501775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 EDGEHILL DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537051449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 EDGEHILL DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537051449",
            "telephone_number": "414-333-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "HEATHER",
        "middle_name": "DAWN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "045567",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "248348",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "54123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.