Lindsey Ann Tillack, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

25MA09672400 Issued in NJ

Practice address

703 Main St
Paterson, NJ 07503-2621

Phone

(973) 754-2222

NPI assigned

Jul 22, 2010

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

Medicare fee-for-service enrollment

Enrolled in NJ

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

Emergency Medicine

Education

Albany Medical College of Union University, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Passaic River Physicians LLCGroup PAC ID 4486041514, 57 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Passaic River Physicians, LLC

  • Emergency Medicine Physician
  • Paterson, NJ
  • NPI 1962162644
  Medicare reassignment Care Compare group NPD
• St. Joseph'S Emergency Physicians Inc

  • Emergency Medical Services (Emergency Medicine) Physician
  • Paterson, NJ
  • NPI 1568791192
  Medicare reassignment NPD
• St. Joseph'S Healthcare, Inc.

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1497791297
  Medicare reassignment NPD
• Passaic River Physicians, LLC

  • Emergency Medicine Physician
  • Wayne, NJ
  • NPI 1124788807
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1285947911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 ALEXANDER WAY",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070202504",
            "telephone_number": "617-721-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLACK",
        "first_name": "LINDSEY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA09672400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rasheeda S Thomas, LPC
• Shanasia Thomas
• Shannon Mary Thomas, DO
• Vincent Joseph Thomas, CRNA
• Fortunata T Tieng, MD
• Alexandra Timberlake, DO
• Roberto Tirado, NP
• Bernadette Tivenan, M.A., CCC/A
• John P Tomasini I
• Tonys Pharmacy Inc.

• Emergency Medicine Physician in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Emergency Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.