Steven D Tilley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T03407 Issued in MO

Practice address

100 S Jackson St
Perryville, MO 63775-2517

Phone

(573) 547-6233

Fax

(573) 547-6765

NPI assigned

Nov 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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.

State licenses

Practice roles

Locations

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.

• Clarkson Optometry, Inc

  • Optometrist
  • Ellisville, MO
  • NPI 1497155345
  Medicare reassignment NPD
• Clarkson Optometry Inc

  • Optometrist
  • Perryville, MO
  • NPI 1629103981
  NPD
• Clarkson Optometry Inc

  • Optometrist
  • Elk River, MN
  • NPI 1952992976
  NPD
• Moreland Eyecare LLC

  • Optometrist
  • Anna, IL
  • NPI 1346468717
  NPD (past)

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1699766014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E NORTH ST",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251205",
            "telephone_number": "636-200-4393",
            "fax_number": "636-938-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JACKSON ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637752517",
            "telephone_number": "573-547-6233",
            "fax_number": "573-547-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEY",
        "first_name": "STEVEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03407",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009101",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699766014",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terrace Gardens Retirement Center
• Terrace Gardens Retirement Center Inc.
• The Estates of Perryville, LLC
• Therapy Solutions, LLC
• Everett A Tilley, O.D.
• Dianne Toycen, CRNA
• Tricorex Inc
• Kerri Urhahn
• Cody James Van de Ven, DPT
• Wal-Mart Stores East LP

• Optometrist in Perryville, MO
• Providers in Perryville, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.