NPIMap

Individual provider Active NPI

Theron C Tilgner, D.O.

  • Orthopaedic Surgery Physician
  • Lake Havasu City, AZ
National Provider Identifier
1497724413
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
3501 Issued in AZ
Practice address
387 Lake Havasu Ave S Ste 101
Lake Havasu City, AZ 86403-9306
Phone
(928) 854-3333
Fax
(928) 854-3335
NPI assigned
Mar 14, 2006
Last updated
Feb 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 3501 AZ Primary

Addresses

Primary practice location

387 Lake Havasu Ave S Ste 101
Lake Havasu City, AZ 86403-9306

Mailing address

387 Lake Havasu Ave S Ste 101
Lake Havasu City, AZ 86403-9306
Phone (928) 854-3333

Other identifiers 1

IdentifierTypeStateIssuer
496324MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060221000688 AZ Practitioner - Orthopedic Surgery 8820041353 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convergence Health LLCGroup PAC ID 2961988969, 2 clinicians

Practice addresses (Care Compare)

1200 W Mohave Rd
Parker, AZ 85344-6349
Phone (928) 669-7435

297 Lake Havasu Ave S
Suite 108
Lake Havasu City, AZ 86403-6526
Phone (928) 854-3333

5601 N Hwy 95
Suite 714
Lake Havasu City, AZ 86403
Phone (928) 538-4325

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
19.01 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
63.36

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement15
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3501AZMDOrthopaedic Surgery Physician
21041SCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Paz Regional Hospital Inc Current Accepting new patients
Kingman Healthcare, Inc Family Medicine Current Accepting new patients
Theron C Tilgner D O LLC CurrentSince Feb 23, 2025 Accepting new patients
Kingman Healthcare, Inc Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Convergence Health LLC CurrentSince Nov 2, 2025 Accepting new patients
Theron C Tilgner D O LLC Orthopaedic Surgery CurrentSince Jan 1, 2006 Accepting new patients
Kingman Healthcare, Inc CurrentSince Aug 1, 2025 Accepting new patients
Tri State Care Flight, LLC Past Accepting new patients
Tri-State Orthopedic Institute, P.C. Orthopaedic Surgery Past Accepting new patients
Hospital Medicine Consultants of Anderson, LLC PastSince Jul 30, 2010 Accepting new patients

Locations

1739 E Beverly Ave
Ste 102
Kingman, AZ 86409
Phone (928) 681-8693

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

3801 Santa Rosa Dr
Kingman, AZ 86401
Phone (928) 263-5000

1720 Mesquite Ave
Ste 102
Lake Havasu City, AZ 86403
Phone (928) 255-3850

387 Lake Havasu Ave S
Ste 101
Lake Havasu City, AZ 86403
Phone (928) 854-3333

5601 Highway 95 N
Ste 714
Lake Havasu City, AZ 86404
Phone (928) 538-4325

297 Lake Havasu Ave S
Ste 108
Lk Havasu Cty, AZ 86403
Phone (928) 854-3333

1200 W Mohave Rd
Parker, AZ 85344
Phone (928) 669-7300

1713 S Kofa Ave
Ste F
Parker, AZ 85344
Phone (520) 669-1666

Interoperability endpoints

  • Direct secure messaging: bli9400@yourcarecommunity.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: theron.tilgner.p1@direct.elkochc.nextgenshare.com
  • Direct secure messaging: therontilgner@lprh.medalliesdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice of Havasu, Inc.Lake Havasu City, AZ, CCN 031543 Hospice W-2 Managing Employee Nov 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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 6

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1497724413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 LAKE HAVASU AVE S STE 101",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864039306",
            "telephone_number": "928-854-3333",
            "fax_number": "928-854-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 LAKE HAVASU AVE S STE 101",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864039306",
            "telephone_number": "928-854-3333",
            "fax_number": "928-854-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILGNER",
        "first_name": "THERON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "496324",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.