Timothy H Tillo, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO1862 Issued in FL

Practice address

12276 San Jose Blvd
Ste 606
Jacksonville, FL 32223-8672

Phone

(904) 224-2001

Fax

(904) 260-1523

NPI assigned

Apr 17, 2006

Last updated

Apr 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Podiatry Associates of Florida, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Clearwater, FL
  • NPI 1255432746
  Medicare reassignment NPD
• Podiatry Associates of Florida Inc

  • Podiatrist
  • Jacksonville, FL
  • NPI 1417137183
  NPD
• Podiatry Associates of Florida Inc

  • Foot & Ankle Surgery Podiatrist
  • Jacksonville, FL
  • NPI 1588765036
  NPD

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1154385029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 SPRING GLEN RD",
            "address_2": "STE 402",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075906",
            "telephone_number": "904-224-2001",
            "fax_number": "904-224-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD",
            "address_2": "STE 606",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238672",
            "telephone_number": "904-224-2001",
            "fax_number": "904-260-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLO",
        "first_name": "TIMOTHY",
        "middle_name": "H",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO1862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noah Tillman, DC
• Shannon E Tillman, CMA
• Sharicka Michelle Tillman
• Shaundria Tillman, LPN
• Toni Tillman
• Brent Justin Tilseth, M.D.
• Dan'N Ebby Khaelle Tima
• Dana Timar, PNP-AC
• Curtis Timberlake
• Jenna Timko

• Podiatrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.