Ilana Tidus, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

011226 Issued in AZ

Practice address

50 N Perry St
Pontiac, MI 48342-2217

Phone

(248) 338-5392

Fax

(248) 338-5567

NPI assigned

Apr 19, 2021

Sex

Female

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 AZ

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

At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Professional Services PCGroup PAC ID 6901707272, 107 clinicians

Emergency Group of Arizona Professional CorporationGroup PAC ID 1355596644, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Abrazo Scottsdale Campus Hospital, Phoenix, AZ, CCN 030083
• Abrazo Arrowhead Hospital Hospital, Glendale, AZ, CCN 030094
• Abrazo Central Campus Hospital, Phoenix, AZ, CCN 030030
• Banner Estrella Medical Center Hospital, Phoenix, AZ, CCN 030115

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Group of Arizona Professional Corporation

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1215275433
  Medicare reassignment Care Compare group NPD
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1518984210
  Medicare reassignment Care Compare group NPD
• Arizona Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1154860674
  Medicare reassignment NPD
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Apache Junction, AZ
  • NPI 1205273406
  NPD
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • San Tan Valley, AZ
  • NPI 1902936164
  NPD
• Arizona Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1093254419
  NPD (past)

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

• Banner Estrella Medical Center

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1275566200
  Care Compare affiliation
• VHS Acquisition Subsidiary Number 1 Inc

  dba Abrazo Scottsdale Campus

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1326022732
  Care Compare affiliation
• VHS of Arrowhead, Inc

  dba Abrazo Arrowhead Campus

  • General Acute Care Hospital
  • Glendale, AZ
  • NPI 1326022765
  Care Compare affiliation
• VHS of Arrowhead, Inc.

  dba Abrazo Peoria Emergency Center

  • General Acute Care Hospital
  • Peoria, AZ
  • NPI 1801340781
  Care Compare affiliation
• VHS of Phoenix Inc

  dba Abrazo Central Campus

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1477537363
  Care Compare affiliation

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1447831623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-338-5392",
            "fax_number": "248-338-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N PERRY ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422217",
            "telephone_number": "248-338-5392",
            "fax_number": "248-338-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDUS",
        "first_name": "ILANA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "011226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Thompson
• Rebecca Thompson, RN
• Sylvia Lyn Thompson, PHYSICAL THERAPIST
• Jahnavi Thummaluru
• Wissam Thweni
• Sandra Lynne Tillier
• Charla Times-Pinkston
• Michelle Times
• Malinda Timney
• Amber Tirmizi

• Emergency Medicine Physician in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.