Individual provider Active NPI

Daniel Bishop Tiller II, DO

  • Sports Medicine (Family Medicine) Physician
  • Alexandria, VA
National Provider Identifier
1396242913
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
0102205902 Issued in VA
Practice address
6355 Walker LN Ste 500
Alexandria, VA 22310-3251
Phone
(703) 797-6970
Fax
(703) 922-3479
NPI assigned
Apr 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 0102205902 VA Primary

Addresses

Primary practice location

6355 Walker LN Ste 500
Alexandria, VA 22310-3251

Mailing address

PO Box 37189
Baltimore, MD 21297-3189
Phone (571) 423-5699

Other practice location 1

611 Denbigh Blvd
Newport News, VA 23608-4415
Phone (757) 594-3800

Other names 1

  • Dr. Daniel Bishop Tiller II Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20200909003234 DC Practitioner - Sports MedicinePractitioner - Family Practice 2163775321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3299 Woodburn Rd
Annandale, VA 22003-7326
Phone (703) 205-2626

3300 Gallows Rd
Falls Church, VA 22042-3300

6355 Walker LN
Alexandria, VA 22310-3251

Hospital & facility affiliations

  • Inova Alexandria Hospital Hospital, Alexandria, VA, CCN 490040
  • Inova Mount Vernon Hospital Hospital, Alexandria, VA, CCN 490122
  • Inova Fair Oaks Hospital Hospital, Fairfax, VA, CCN 490101
  • Inova Fairfax Hospital Hospital, Falls Church, VA, CCN 490063

Merit-based Incentive Payment System (MIPS)

Final score
83.36 of 100Reported as group
Quality
73.03
Promoting interoperability
100
Improvement activities
40
Cost
71.49

Merit-based Incentive Payment System (MIPS)

Final score
93.98 of 100Reported as apm
Quality
87.97
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Jan 2, 2023 Accepting new patients
Inova Physician Partners, LLC Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Inova Health Care Services CurrentSince Jan 2, 2023 Accepting new patients
Inova Physician Partners, Inc. - Specialists PastSince Oct 9, 2022 Accepting new patients

Locations

6355 Walker Ln
Ste 500
Alexandria, VA 22310
Phone (703) 373-3718

3299 Woodburn Rd
Ste 370
Annandale, VA 22003
Phone (703) 573-2066

3914 Centreville Rd
Ste 250
Chantilly, VA 20151
Phone (703) 435-1223

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Interoperability endpoints

  • Direct secure messaging: dtiller1094004@soc.inova.org

Organizations & group practices 4

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 5

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1396242913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37189",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212973189",
            "telephone_number": "571-423-5699",
            "fax_number": "571-423-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 WALKER LN STE 500",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223103251",
            "telephone_number": "703-797-6970",
            "fax_number": "703-922-3479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 Denbigh Blvd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236084415",
            "country_code": "US",
            "telephone_number": "757-594-3800",
            "fax_number": "757-594-3818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLER",
        "first_name": "DANIEL",
        "middle_name": "BISHOP",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": "0102205902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIEL",
            "last_name": "TILLER",
            "middle_name": "BISHOP",
            "prefix": "DR.",
            "suffix": "II",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.