Individual provider Active NPI

John Howell Tiller, M.D.

  • Family Medicine Physician
  • Miramar, FL
National Provider Identifier
1376754382
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME70006 Issued in FL
Practice address
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Phone
(877) 866-7123
Fax
(855) 855-2792
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X ME70006 FL
Family Medicine Physician 207Q00000X ME70006 FL Primary

Addresses

Primary practice location

3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308

Mailing address

1674 Meridian Ave Ste 204
Miami Beach, FL 33139-2825
Phone (305) 534-9054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160614002056 FL Practitioner - Plastic and Reconstructive SurgeryPractitioner - Peripheral Vascular DiseasePractitioner - Family Practice 2264723733 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Post Acute Care Clinicians, LLC Family Medicine CurrentSince Apr 11, 2016 Accepting new patients
Florida Post Acute Care Clinicians, LLC Family Medicine CurrentSince Apr 11, 2016 Accepting new patients

Locations

5888 Blanding Blvd
Jacksonville, FL 32244
Phone (904) 612-7385

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

1780 N Jefferson Hwy
Monticello, FL 32344
Phone (800) 708-4008

1800 NE 168th St
North Miami Beach, FL 33162
Phone (305) 917-1800

1717 W Avery St
Pensacola, FL 32501
Phone (850) 434-2355

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1376754382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1674 MERIDIAN AVE STE 204",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331392825",
            "telephone_number": "305-534-9054",
            "fax_number": "305-534-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "877-866-7123",
            "fax_number": "855-855-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "JOHN",
        "middle_name": "HOWELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME70006",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME70006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.