Individual provider Active NPI

Mathew Andrew Tilson, APNP

  • Nurse Practitioner
  • Milwaukee, WI
National Provider Identifier
1467763813
Registry record updated Jul 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10069 Issued in WI
Practice address
2741 W Layton Ave Ste 201
Milwaukee, WI 53221-2600
Phone
(414) 672-8050
NPI assigned
Jun 30, 2010
Last updated
Jul 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10069 WI Primary
Registered Nurse 163W00000X 172644-030 WI

Addresses

Primary practice location

2741 W Layton Ave Ste 201
Milwaukee, WI 53221-2600

Mailing address

2018 N 114TH St
Wauwatosa, WI 53226-2214
Phone (414) 839-5795

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20200615001419 WI Practitioner - Nurse Practitioner 6507288800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Turgut Zia SCGroup PAC ID 0547455669, 3 clinicians
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians

Practice addresses (Care Compare)

10700 W Howard Ave
Suite B
Greenfield, WI 53228-1321
Phone (414) 545-1120

2741 W Layton Ave
Milwaukee, WI 53221-2600

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6000

3503 E Layton Ave
Unit 100
Cudahy, WI 53110-1408
Phone (414) 489-0270

9035 N 97TH St
Milwaukee, WI 53224-1603
Phone (414) 368-3311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
172644-030WIMDRegistered Nurse
10069WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Turgut Zia SC CurrentSince Jun 1, 2020 Accepting new patients
MDS Lab LLC Current Accepting new patients

Locations

10700 W Howard Ave
Ste B
Greenfield, WI 53228
Phone (414) 460-3195

2741 W Layton Ave
Ste 201
Milwaukee, WI 53221
Phone (414) 672-7343

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25700/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mathew.tilson.1@25700.direct.athenahealth.com

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

Hospital & facility affiliations 4

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1467763813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 N 114TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262214",
            "telephone_number": "414-839-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2741 W LAYTON AVE STE 201",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212600",
            "telephone_number": "414-672-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILSON",
        "first_name": "MATHEW",
        "middle_name": "ANDREW",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "10069",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "172644-030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.