Individual provider Active NPI

Lesa Rice Tilley, CRNA

  • Certified Registered Nurse Anesthetist
  • Bossier City, LA
National Provider Identifier
1073582763
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP116957 Issued in TX
Practice address
403 Magazine CT
Bossier City, LA 71111-6263
Phone
(228) 365-7568
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 628349 TX
Registered Nurse 163W00000X 139177 LA
Registered Nurse 163W00000X AP07128 LA
Certified Registered Nurse Anesthetist 367500000X AP07128 LA
Certified Registered Nurse Anesthetist 367500000X RN139177 IN
Certified Registered Nurse Anesthetist 367500000X AP116957 TX Primary

Addresses

Primary practice location

403 Magazine CT
Bossier City, LA 71111-6263

Mailing address

416 Bridgewater Cir
Benton, LA 71006-8807
Phone (318) 525-8688

Other practice location 1

5165 McCarty Ln
Lafayette, IN 47905-8764
Phone (765) 448-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ltilley@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA, IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20091123000203 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628117132 Reassigns benefits to 2 organizations
I20151202002488 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628117132 Reassigns benefits to 1 organization
I20240404000642 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628117132 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians
Arnett Clinic LLCGroup PAC ID 0749184380, 401 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

5165 McCarty LN
Lafayette, IN 47905-8764
Phone (765) 448-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
139177LAMDRegistered Nurse
AP07128LAMDRegistered Nurse
628349TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2014 Accepting new patients
Christus Good Shepherd Medical Center CurrentSince Jun 22, 2022 Accepting new patients
Arnett Clinic, LLC CurrentSince Apr 1, 2024 Accepting new patients
Willis Knighton Medical Center Inc. Crna Group Nurse Anesthetist, Certified Registered CurrentSince Oct 5, 2015 Accepting new patients
Arnett Clinic, LLC CurrentSince Apr 1, 2024 Accepting new patients
Christus Good Shepherd Medical Center Nurse Anesthetist, Certified Registered CurrentSince Jun 22, 2022 Accepting new patients
Arnett Clinic, LLC Current Accepting new patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2014 Accepting new patients
Med-Trans Corporation Past Accepting new patients

Locations

8016 Reliable Pkwy
Chicago, IL 60686

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

5165 McCarty Ln
Rm 28A
Lafayette, IN 47905

2600 Greenbush St
Lafayette, IN 47904

5165 McCarty Ln
Lafayette, IN 47905
Phone (800) 899-8448

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

4500 Medical Center Dr
McKinney, TX 75069
Phone (972) 547-8190

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.

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": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1073582763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 BRIDGEWATER CIR",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710068807",
            "telephone_number": "318-525-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 MAGAZINE CT",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711116263",
            "telephone_number": "228-365-7568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5165 McCarty Ln",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479058764",
            "country_code": "US",
            "telephone_number": "765-448-8000",
            "fax_number": "765-838-4758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "LESA",
        "middle_name": "RICE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "628349",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "139177",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "AP07128",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP07128",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "RN139177",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP116957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ltilley@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5165 McCarty Ln",
            "city": "Lafayette",
            "state": "IN",
            "country_code": "US",
            "postal_code": "479058764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.