NPIMap

Individual provider Active NPI

Robert J Tiller, MD

  • Family Medicine Physician
  • Greenwood, SC
National Provider Identifier
1235156233
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18462 Issued in SC
Practice address
155 Academy Avenue
Greenwood, SC 29646
Phone
(864) 725-4865
Fax
(864) 725-4883
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 18462 SC Primary

Addresses

Primary practice location

155 Academy Avenue
Greenwood, SC 29646

Mailing address

155 Academy Avenue
Greenwood, SC 29646
Phone (864) 725-4865

Other identifiers 1

IdentifierTypeStateIssuer
L22312MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rtiller127887@selfregional.direct-ci.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20070517000743 SC Practitioner - Family PracticePractitioner - Hospice/Palliative Care 8426155961 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Hospice/Palliative Care
Education
Indiana University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians
Self Regional HealthcareGroup PAC ID 4082527742, 159 clinicians
Self Regional Healthcare PartnersGroup PAC ID 1557606118, 36 clinicians

Practice addresses (Care Compare)

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4398

155 Academy Ave
Greenwood, SC 29646-3869
Phone (864) 725-4865

300 Ridge Medical Plaza Rd
Edgefield, SC 29824-4525
Phone (803) 637-3174

Hospital & facility affiliations

  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071
  • Edgefield County Healthcare an Affiliate of Self R Hospital, Edgefield, SC, CCN 421304
  • Abbeville Area Medical Center Hospital, Abbeville, SC, CCN 421301

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Self Regional Healthcare Family Medicine CurrentSince Apr 1, 2001 Accepting new patients
Self Medical Group Current Accepting new patients
Self Regional Healthcare Partners CurrentSince Jan 1, 2019 Accepting new patients
Self Medical Group Family Medicine CurrentSince Jan 21, 2020 Accepting new patients
Self Regional Healthcare Partners Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients
Self Regional Healthcare Past Accepting new patients
Self Regional Healthcare Past Accepting new patients
Self Regional Healthcare Family Medicine Past Accepting new patients

Locations

901 W Greenwood St
Ste 9
Abbeville, SC 29620
Phone (864) 366-9681

901 W Greenwood St
Ste 8
Abbeville, SC 29620
Phone (644) 599-6811

300 Ridge Medical Plaza Rd
Edgefield, SC 29824
Phone (803) 637-3174

1325 Spring St
Greenwood, SC 29646
Phone (864) 227-4111

102 Rockcreek Blvd
Greenwood, SC 29649
Phone (864) 725-5020

155 Academy Ave
Greenwood, SC 29646
Phone (864) 725-4865

104 Wells Ave
Greenwood, SC 29646

22580 Highway 76 E
Ste 300
Laurens, SC 29360
Phone (864) 725-4183

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

157B S Greenwood Ave
Ware Shoals, SC 29692
Phone (864) 456-3447

Interoperability endpoints

  • Direct secure messaging: rtiller127887@selfregional.direct-ci.net

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1235156233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 ACADEMY AVENUE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29646",
            "telephone_number": "864-725-4865",
            "fax_number": "864-725-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 ACADEMY AVENUE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29646",
            "telephone_number": "864-725-4865",
            "fax_number": "864-725-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "18462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L22312",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rtiller127887@selfregional.direct-ci.net",
            "affiliation": "N",
            "address_1": "155 Academy Avenue",
            "city": "Greenwood",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.