Tina Nannette Tillis, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME64518 Issued in FL

Practice address

3890 Dunn Ave
#902
Jacksonville, FL 32218-6428

Phone

(904) 345-3473

NPI assigned

Feb 2, 2006

Last updated

Feb 12, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Yale University School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.36 of 100Reported as individual

Quality

96.71

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Tntmd PA

  • Ophthalmology Physician
  • Jacksonville, FL
  • NPI 1467867168
  Medicare reassignment NPD Authorized official
• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians Inc

  • Ophthalmology Physician
  • Jacksonville, FL
  • NPI 1386804656
  NPD
• University of Florida Jacksonville Physicians, Inc.

  dba UF Health Imaging Center-Baymeadows

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD
• Alpha Ambulatory Surgery Inc.

  • Ophthalmologic Surgery Clinic/Center
  • Tallahassee, FL
  • NPI 1487642195
  NPD (past)
• Isaac Moore MD

  dba Alpha Eye Clinic

  • Ophthalmology Physician
  • Tallahassee, FL
  • NPI 1437147147
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1174595318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 10525",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322470525",
            "telephone_number": "904-345-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 DUNN AVE",
            "address_2": "#902",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186428",
            "telephone_number": "904-345-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLIS",
        "first_name": "TINA",
        "middle_name": "NANNETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME64518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3732029-00",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00061611",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000581941F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Alexandra Tilbrook, AUD
• Ralph Thomas Tilbury, M.D.
• Beatrice Joy Tiller
• Bryce R Tiller, MD
• Mallory Lynn Tillis, SLP
• Tiffany Armika Tillman-Williams, RN
• Nancy T. Tillman, RN
• Noah Tillman, DC
• Shannon E Tillman, CMA
• Sharicka Michelle Tillman

• Ophthalmology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2014; 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.
• 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.