NPIMap

Individual provider Active NPI

Steven M Tillem, M.D.

  • Urology Physician
  • Astoria, NY
National Provider Identifier
1235119090
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
1982311 Issued in NY
Practice address
3119 Newtown Ave
Suite 801
Astoria, NY 11102-1350
Phone
(718) 777-2111
Fax
(718) 732-2191
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 1982311 NY Primary

Addresses

Primary practice location

3119 Newtown Ave
Suite 801
Astoria, NY 11102-1350

Mailing address

3119 Newtown Ave
Suite 801
Astoria, NY 11102-1350
Phone (718) 777-2111

Other identifiers 1

IdentifierTypeStateIssuer
02057289MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041015000041 NY Practitioner - Urology 1557321486 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Rutgers New Jersey Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
72.13
Promoting interoperability
91
Improvement activities
40
Cost
75.81

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1982311NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newyork-Presbyterian/Queens CurrentSince Oct 27, 2009 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Newyork-Presbyterian-Queens CurrentSince Oct 27, 2009 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Jun 17, 2017 Accepting new patients
New York Queens Medicine and Surgery, P.C. CurrentSince Jun 17, 2017 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients
Pension Committee Joint Industry Board Past Accepting new patients
The Mount Sinai Hospital Past Accepting new patients

Locations

2322 30th Ave
Astoria, NY 11102
Phone (718) 267-2763

17660 Union Tpke
Ste 200
Fresh Meadows, NY 11366
Phone (646) 742-8800

18219 Horace Harding Expy
Fresh Meadows, NY 11365
Phone (718) 670-1415

16303 Horace Harding Expy
Fl 2
Fresh Meadows, NY 11365
Phone (718) 888-9121

17561 Hillside Ave
Ste 402
Jamaica, NY 11432
Phone (718) 670-1021

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Philadelphia, PA 19195

Organizations & group practices 9

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 7

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1235119090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3119 NEWTOWN AVE",
            "address_2": "SUITE 801",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021350",
            "telephone_number": "718-777-2111",
            "fax_number": "718-732-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3119 NEWTOWN AVE",
            "address_2": "SUITE 801",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021350",
            "telephone_number": "718-777-2111",
            "fax_number": "718-732-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEM",
        "first_name": "STEVEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "1982311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02057289",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.