Jeremy David Tillim, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

G57659 Issued in CA

Practice address

5000 Macarthur Blvd
PMB 9002
Oakland, CA 94613-1301

Phone

(925) 884-2365

Fax

(925) 884-2375

NPI assigned

Nov 7, 2005

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in CA

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

University of Nevada School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Highland Hospital Hospital, Oakland, CA, CCN 050320
• Eden Medical Center Hospital, Castro Valley, CA, CCN 050488

Merit-based Incentive Payment System (MIPS)

Final score

95.17 of 100Reported as group

Quality

86.93

Promoting interoperability

100

Improvement activities

40

Cost

72.6

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtillim14604@alamedahs.direct-ci.com

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.

• Alameda Health System

  • Surgery Physician
  • Oakland, CA
  • NPI 1740332931
  Medicare reassignment Care Compare group NPD
• Alameda Health System

  • Clinic/Center
  • Alameda, CA
  • NPI 1124446158
  NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Newark, CA
  • NPI 1497956288
  NPD
• Alameda Health System

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1083815872
  NPD (past)

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

• Alameda Health System

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1083815872
  Care Compare affiliation
• Alameda Health System

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1396764353
  Care Compare affiliation
• Alameda Health System

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1700087590
  Care Compare affiliation
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Castro Valley, CA
  • NPI 1063812907
  Care Compare affiliation

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364515200000",
    "number": "1366423410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 MACARTHUR BLVD",
            "address_2": "PMB 9002",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946131301",
            "telephone_number": "925-884-2365",
            "fax_number": "925-884-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 MACARTHUR BLVD",
            "address_2": "PMB 9002",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946131301",
            "telephone_number": "925-884-2365",
            "fax_number": "925-884-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLIM",
        "first_name": "JEREMY",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2013-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G57659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G576590",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G576590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenny Tiet
• Joseph W Tietz, PH.D.
• Star Ramona Tiffany
• Donna D Tigno, M.D.
• Karen Elizabeth Tijero
• Shonisha Tillis
• Tya Darlene Tillis
• Samiyyah Tillman
• Masina Tillo
• Shawniese Rochelle Tilmon, PH.D.

• Emergency Medicine Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; 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.