Michael Ray Tillman, MPT, CSCS, CERT, MDT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1133353 Issued in TX

Practice address

2519 South Lakeline Blvd
Suite 100
Cedar Park, TX 78613-2964

Phone

(512) 331-6200

Fax

(512) 331-6384

NPI assigned

Jun 30, 2006

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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Physical Therapy Specialists, IncGroup PAC ID 2567422538, 238 clinicians

Tillman Physical Therapy and Sports Training Center, IncGroup PAC ID 9638240773, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Tillman Physical Therapy & Sports Training Center, Inc

  • Physical Therapy Clinic/Center
  • Cedar Park, TX
  • NPI 1376579797
  Medicare reassignment Care Compare group NPD Authorized official
• Texas Physical Therapy Specialists, Inc.

  • Physical Therapist
  • New Braunfels, TX
  • NPI 1689781338
  Medicare reassignment Care Compare group NPD
• Texas Physical Therapy Specialists

  • Durable Medical Equipment & Medical Supplies
  • Austin, TX
  • NPI 1568049484
  NPD
• Tillman Physical Therapy & Sports Training

  • Physical Therapist
  • Cedar Park, TX
  • NPI 1477703114
  NPD

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1376571919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 SOUTH LAKELINE BLVD",
            "address_2": "SUITE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132964",
            "telephone_number": "512-331-6200",
            "fax_number": "512-331-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 SOUTH LAKELINE BLVD",
            "address_2": "SUITE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132964",
            "telephone_number": "512-331-6200",
            "fax_number": "512-331-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "MICHAEL",
        "middle_name": "RAY",
        "credential": "MPT, CSCS, CERT, MDT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1133353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Sue Throckmorton, AUD
• Tiffany Simon Kondoff, DDS, PLLC
• Diba Tillery, RN, IBCLC
• Tillman Physical Therapy & Sports Training
• Tillman Physical Therapy & Sports Training Center, Inc
• Michelle L Tilton
• Timberland Medical Group
• Timberland Medical Group
• De'John L Tinsley, RBT-23-311294
• TLC Dental, PLLC

• Physical Therapist in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.