Individual provider Active NPI

Todd J Pillen, PA-C

  • Surgical Physician Assistant
  • Denver, CO
National Provider Identifier
1508812629
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA.0003886 Issued in CO
Practice address
2535 S Downing St
Suite 380
Denver, CO 80210-5847
Phone
(303) 778-5797
Fax
(303) 778-5205
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 2940 GA
Surgical Physician Assistant 363AS0400X PA06207 TX
Pediatric Surgery Physician 2086S0120X PA06207 TX
Surgical Physician Assistant 363AS0400X PA.0003886 CO Primary

Addresses

Primary practice location

2535 S Downing St
Suite 380
Denver, CO 80210-5847

Mailing address

2535 S Downing St
Suite 380
Denver, CO 80210-5847
Phone (303) 778-5797

Other identifiers 1

IdentifierTypeStateIssuer
098802401MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090928000320 TX Practitioner - Physician Assistant 3274689674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Dermatology PLLCGroup PAC ID 6305092859, 12 clinicians

Practice addresses (Care Compare)

400 Enterprise Blvd BLDG
Suite 2
Corpus Christi, TX 78411
Phone (361) 882-5560

4141 S Staples St
Suite 300
Corpus Christi, TX 78411-0002
Phone 36188255601130

5920 Saratoga Blvd
Suite 470
Corpus Christi, TX 78414-4108
Phone (361) 882-5560

Merit-based Incentive Payment System (MIPS)

Final score
74.77 of 100Reported as group
Quality
51.47
Promoting interoperability
88
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2940GAMDPediatric Surgery Physician
PA06207TXMDPediatric Surgery Physician
PA.0003886COMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA Past Accepting new patients
Portercare Adventist Health System Past Accepting new patients

Organizations & group practices 3

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1508812629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 S DOWNING ST",
            "address_2": "SUITE 380",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802105847",
            "telephone_number": "303-778-5797",
            "fax_number": "303-778-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 S DOWNING ST",
            "address_2": "SUITE 380",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802105847",
            "telephone_number": "303-778-5797",
            "fax_number": "303-778-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILLEN",
        "first_name": "TODD",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "GA",
            "license": "2940",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA06207",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "PA06207",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "PA.0003886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098802401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.