Individual provider Active NPI

Samuel David Tillmans, M.D.

  • Anesthesiology Physician
  • Duluth, MN
National Provider Identifier
1366977787
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
69731 Issued in MN
Practice address
400 E 3Rd St
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
Apr 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 69731 MN Primary

Addresses

Primary practice location

400 E 3Rd St
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MN, MI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210813000047 WI Practitioner - Anesthesiology 5092052332 Reassigns benefits to 1 organization
I20210813002001 MN Practitioner - Anesthesiology 5092052332 Reassigns benefits to 1 organization
I20250902000562 MI Practitioner - Anesthesiology 5092052332 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Michigan-Alpena PLLCGroup PAC ID 6406260124, 25 clinicians
The Duluth Clinic LTDGroup PAC ID 2567374283, shared by 25 NPIs, 1,135 clinicians

Practice addresses (Care Compare)

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone (906) 774-1313

3500 Tower Ave
Superior, WI 54880-5335
Phone (715) 395-5454

400 E 3Rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Hospital & facility affiliations

  • Essentia Health St Mary'S Medical Center Hospital, Duluth, MN, CCN 240002
  • Dickinson County Memorial Hospital Hospital, Iron Mountain, MI, CCN 230055
  • Essentia Health Duluth Hospital, Duluth, MN, CCN 240019
  • Marshfield Medical Center Hospital, Iron Mountain, MI, CCN 231342

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Michigan-Alpena PLLC Anesthesiology CurrentSince Jun 26, 2025 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
The Duluth Clinic, LTD Anesthesiology CurrentSince Aug 9, 2021 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 9, 2021 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
The Duluth Clinic, LTD Anesthesiology CurrentSince Aug 9, 2021 Accepting new patients

Locations

3401 Ludington St
Escanaba, MI 49829
Phone (906) 786-3311

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

1101 9th St N
Virginia, MN 55792
Phone (218) 305-0000

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

3500 Tower Ave
Ste 1
Superior, WI 54880
Phone (715) 395-5457

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 6

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 3

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": "1492905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1366977787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMANS",
        "first_name": "SAMUEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-23",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MN",
            "license": "69731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.