NPIMap

Individual provider Active NPI

Theresa Mae Tilton, MD

  • Diagnostic Radiology Physician
  • Lexington, KY
National Provider Identifier
1497752588
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
34103 Issued in KY
Practice address
3021 Windermere Road
Lexington, KY 40502-2950
Phone
(859) 278-5270
Fax
(229) 928-3492
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME74267 FL
Diagnostic Radiology Physician 2085R0202X 34103 KY Primary

Addresses

Primary practice location

3021 Windermere Road
Lexington, KY 40502-2950

Mailing address

23625 Commerce Park
Suite 204
Beachwood, OH 44122-5845
Phone (216) 255-5727

Other identifiers 9

IdentifierTypeStateIssuer
300138462OtherRR
488628MedicaidAZ
808323500MedicaidID
P00922044OtherKYRXR MEDICARE
42591OtherBCBS
03083272MedicaidNY
221123800MedicaidMD
64927270MedicaidKY
263513500MedicaidFL

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME74267FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin & Seidelmann Inc Diagnostic Radiology Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Apex Radiology Past Accepting new patients
Sheridan Radiology Services of West Florida, Inc. Diagnostic Radiology Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Osu Health System-Hospital at Home Past Accepting new patients
FSH Radiology Inc Diagnostic Radiology Past Accepting new patients
Tampa Bay Radiology Consultants Diagnostic Radiology Past Accepting new patients
Eastpointe Radiologists, PC Diagnostic Radiology Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 9

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1497752588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23625 COMMERCE PARK",
            "address_2": "SUITE 204",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225845",
            "telephone_number": "216-255-5727",
            "fax_number": "866-458-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 WINDERMERE ROAD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405022950",
            "telephone_number": "859-278-5270",
            "fax_number": "229-928-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILTON",
        "first_name": "THERESA",
        "middle_name": "MAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME74267",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KY",
            "license": "34103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "300138462",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "488628",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "808323500",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RXR MEDICARE",
            "identifier": "P00922044",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "42591",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03083272",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221123800",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64927270",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263513500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.