Individual provider Active NPI

Monica Ann Tilley

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1659912384
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95018237 Issued in CA
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
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211005001103 CA Practitioner - Nurse Practitioner 2567896186 Reassigns benefits to 1 organization
I20250930002232 FL Practitioner - Nurse Practitioner 2567896186

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
Monica Perlman MD IncGroup PAC ID 8820035884, 357 clinicians

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 100Reported as group
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

LicenseStateTypeSpecialty
70453MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew 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 and National Provider Directory roles.

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

Verify at the official NPI Registry.