Charles R Tilley Jr.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001775 Issued in IA

Practice address

180 10TH St SE Ste 201
Le Mars, IA 51031-2557

Phone

(712) 546-4624

Fax

(712) 546-9395

NPI assigned

Jan 12, 2007

Last updated

Oct 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Sanford School of Medicine of University of South Dakota, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Plains Area Mental Health IncGroup PAC ID 5395649743, 24 clinicians

Northwest Iowa Hospital CorporationGroup PAC ID 0749198026, 139 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakes Regional Healthcare Hospital, Spirit Lake, IA, CCN 160124
• Floyd Valley Healthcare Hospital, Le Mars, IA, CCN 161368
• Cherokee Regional Medical Center Hospital, Cherokee, IA, CCN 161362

Merit-based Incentive Payment System (MIPS)

Final score

88.8 of 100Reported as apm

Quality

82.54

Promoting interoperability

89.05

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• Northwest Iowa Hospital Corporation

  dba St. Luke's Regional Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Sioux City, IA
  • NPI 1215962550
  Medicare reassignment Care Compare group NPD
• Plains Area Mental Health, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Le Mars, IA
  • NPI 1356198147
  Care Compare group NPD
• Plains Area Mental Health, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Le Mars, IA
  • NPI 1801867734
  NPD
• Winnebago IHS Hospital Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Winnebago, NE
  • NPI 1154451730
  NPD (past)
• Winnebago Indian Health Service

  • Clinic/Center
  • Winnebago, NE
  • NPI 1801260526
  NPD (past)

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

• Floyd Valley Healthcare

  • Critical Access Hospital
  • Le Mars, IA
  • NPI 1326109315
  Care Compare affiliation
• Lakes Regional Healthcare

  • General Acute Care Hospital
  • Spirit Lake, IA
  • NPI 1508862012
  Care Compare affiliation
• Sioux Valley Memorial Hospital Association

  dba Cherokee Regional Medical Center

  • Critical Access Hospital
  • Primghar, IA
  • NPI 1689640500
  Care Compare affiliation

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1467502286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510310070",
            "telephone_number": "712-546-4624",
            "fax_number": "712-546-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 10TH ST SE STE 201",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "510312557",
            "telephone_number": "712-546-4624",
            "fax_number": "712-546-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1409",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gary M Tillman, C.R.N.A.
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• True Health Chiropractic, LLC
• Peyton Turner, LMSW
• Katie Ann Van Den Hul

• Physician Assistant in Le Mars, IA
• Providers in Le Mars, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.