Individual provider Active NPI

Douglas M. Tilton, M.D.

  • Diagnostic Radiology Physician
  • Ft. Hood, TX
National Provider Identifier
1487844296
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01055369A Issued in IN
Practice address
36000 Darnall Loop, Box 48
Radiology Department
Ft. Hood, TX 76544
Phone
(254) 288-8300
Fax
(254) 288-8924
NPI assigned
Jul 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 01055369A IN
Diagnostic Radiology Physician 2085R0202X 01055369A IN Primary

Addresses

Primary practice location

36000 Darnall Loop, Box 48
Radiology Department
Ft. Hood, TX 76544

Mailing address

36000 Darnall Loop, Box 48
Radiology Department
Ft. Hood, TX 76544
Phone (254) 288-8300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180503002141 TX Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 5092947333 Practice locations: Georgetown, TX

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4749 Williams Dr
Suite 333
Georgetown, TX 78633-3711
Phone (512) 698-6746

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01055369AINMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile CR Imaging, LLC Past Accepting new patients

Organizations & group practices 1

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": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1487844296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP, BOX 48",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "FT. HOOD",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-288-8300",
            "fax_number": "254-288-8924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP, BOX 48",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "FT. HOOD",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-288-8300",
            "fax_number": "254-288-8924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILTON",
        "first_name": "DOUGLAS",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-27",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IN",
            "license": "01055369A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01055369A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft. Hood, TX

Sources for this page

Verify at the official NPI Registry.