Michael Tiller, MD

Primary specialty

Trauma Surgery PhysicianTaxonomy code 2086S0127X

License

4301075583 Issued in MI

Practice address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Phone

(202) 425-2103

Fax

(215) 243-4605

NPI assigned

Apr 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

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 and National Provider Directory roles.

• Tower Health Medical Group

  dba Internal Medicine - Tower Health Medical Group

  • Internal Medicine Physician
  • Birdsboro, PA
  • NPI 1609291350
  Medicare reassignment NPD
• University of Penn-Medical Group

  • Gynecologic Oncology Physician
  • Philadelphia, PA
  • NPI 1235527342
  Medicare reassignment NPD
• Tower Health Medical Group

  dba Neonatology - Tower Health Medical Group

  • Neonatal-Perinatal Medicine Physician
  • West Reading, PA
  • NPI 1811088537
  NPD
• Tower Health Medical Group

  dba Breast Health Center Wyomissing Tower Health Medical Group

  • Surgery Physician
  • Wyomissing, PA
  • NPI 1831954353
  NPD
• University of Penn-Medical Group

  • Critical Care Medicine (Anesthesiology) Physician
  • Philadelphia, PA
  • NPI 1235527359
  NPD
• University of Penn-Medical Group

  • Surgical Oncology Physician
  • Philadelphia, PA
  • NPI 1871981985
  NPD

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1356306658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E LULLWOOD AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782122317",
            "telephone_number": "202-425-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "202-425-2103",
            "fax_number": "215-243-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "MI",
            "license": "4301075583",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301075583",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD457338",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "PA",
            "license": "MD457338",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MI",
            "license": "4301075583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356306658",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Min Thwin, MD
• Carlo Alfonso Salazar Tiano, PHARM.D.
• Danielle Nicole Tidmore, LISW
• Carolyn Arlene Tiffany, MD
• Kevin Wade Tiller, RPH
• Alexander A Timchenko, M.D.
• Rachel Tobillo, MD
• Lenard Tol
• Andrew B Toman
• Ashleigh Tomkovich, MD

• Trauma Surgery Physician in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Trauma Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.