Active NPI
Monica Ann Tilley
- Family Nurse Practitioner
- San Diego, CA
National Provider Identifier
1659912384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95018237
- Practice address
- 12843 El Camino Real Ste 203
San Diego, CA 92130-2966 - Phone
- (858) 554-1212
- Fax
- (858) 795-1195
- NPI assigned
- Oct 3, 2019
- Last updated
- Jan 5, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 70453 | ME | |
| Family Nurse Practitioner | 363LF0000X | 95018237 | CA | Primary |
Addresses
Primary practice location
12843 El Camino Real Ste 203
San Diego, CA 92130-2966
Mailing address
9850 Genesee Ave Ste 320
La Jolla, CA 92037-1208
Phone (585) 541-2128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12843 El Camino Real
Suite 203
San Diego, CA 92130-2966
Phone (858) 558-0399
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.17 of 100
- Quality
- 100
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 73.9
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95018237 | CA | MD | Family Nurse Practitioner |
| 70453 | ME | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moore Medical Group Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641340800000",
"number": "1659912384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9850 GENESEE AVE STE 320",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371208",
"telephone_number": "585-541-2128",
"fax_number": "858-795-1195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12843 EL CAMINO REAL STE 203",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921302966",
"telephone_number": "858-554-1212",
"fax_number": "858-795-1195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEY",
"first_name": "MONICA",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-03",
"last_updated": "2022-01-05",
"certification_date": "2022-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "ME",
"license": "70453",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95018237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.