James H Tillman Jr., O.D.
Individual provider Active NPI Optometrist · Andalusia, AL
NPI 1164598215 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164598215
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- S620TA088 (AL)
- Practice address
- 1860 E Three Notch St
Andalusia, AL 36421-2404 - Phone
- (334) 222-2020
- NPI assigned
- Nov 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Andalusia Eye Clinic LLC
Practice addresses (Care Compare)
1860 E Three Notch St
Andalusia, AL 36421-2404
Phone (334) 222-2020
Merit-based Incentive Payment System (MIPS)
- Final score
- 10.83 of 100
- Quality
- 21.67
- Improvement activities
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051013000534 | AL | Practitioner - Optometry | 2365467586 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andalusia Eye Clinic LLC | Optometrist | Current |
Accepting new patients |
Locations
1860 E Three Notch St
Andalusia, AL 36421
Phone (334) 222-2020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | S620TA088 | AL | Yes |
Addresses
Primary practice location
1860 E Three Notch St
Andalusia, AL 36421-2404
Mailing address
PO Box 1517
Andalusia, AL 36420-1226
Phone (334) 222-2020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51531187 | Other | AL | BCBS PROVIDER ID |
Other providers in Andalusia, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.