Jerome Tilles, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

E0170 Issued in TX

Practice address

108 Waydele Circle
San Antonio, TX 78213

Phone

(210) 341-9560

NPI assigned

Dec 2, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Coastal Plains Community MHMR Center

  dba Coastal Plains Community Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, TX
  • NPI 1194104026
  NPD (past)
• Coastal Plains Community MHMR Center

  dba Coastal Plains Community Center

  • Psychiatry Physician
  • Portland, TX
  • NPI 1962552109
  NPD (past)
• Gulf Bend Mental Health Mental Retardation Center

  dba Gulf Bend Center

  • Professional Counselor
  • Victoria, TX
  • NPI 1467434399

  Psychiatry

  NPD (past)
• Regional Employee Assistance Program Inc

  • Cardiovascular Disease Physician
  • Abilene, TX
  • NPI 1073575585
  NPD (past)
• South Texas Psychiatric Associates, P.a.

  • Psychiatry Physician
  • Corpus Christi, TX
  • NPI 1427170075
  NPD (past)
• Vo of Arizona, Inc.

  dba ValueOptions Laboratory Services

  • Clinical Medical Laboratory
  • Glendale, AZ
  • NPI 1447458682
  NPD (past)

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558345629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 WAYDELE CIR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782133345",
            "telephone_number": "210-341-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WAYDELE CIRCLE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78213",
            "telephone_number": "210-341-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLES",
        "first_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "E0170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUESHIELD",
            "identifier": "87130S",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140030103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Viviana Tijerina
• Bryan Anthony Tilghman, DC
• Matrisa F Tilghman, LCDC
• Donna S Tiller, PHD
• Thomas Alton Tiller, DDS, MS
• Jan L Tilley, RD, LD
• Anita Carol Tillman, LBSW
• Kristyn Tillman
• Elizabeth A Tilson, LPC S
• Toni Timaeus

• Psychiatry Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.