Individual provider Active NPI

Chana Tilis, RPA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1487925350
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
015378 Issued in NY
Practice address
5137 Ocean View Ave
Brooklyn, NY 11224-1115
Phone
(646) 709-1551
NPI assigned
Jan 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 015378 NY Primary

Addresses

Primary practice location

5137 Ocean View Ave
Brooklyn, NY 11224-1115

Mailing address

5137 Ocean View Ave
Brooklyn, NY 11224-1115
Phone (646) 709-1551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015378NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1487925350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5137 OCEAN VIEW AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112241115",
            "telephone_number": "646-709-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5137 OCEAN VIEW AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112241115",
            "telephone_number": "646-709-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILIS",
        "first_name": "CHANA",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "015378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.