Tillges Certified Orthotic Prosthetic, Inc.

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

TILLGES CERTIFIED ORTHOTIC PROSTHETIC, INC.

Practice address

817 Portland Ave
Minneapolis, MN 55404-1145

Phone

(612) 341-3660

Fax

(612) 341-3664

NPI assigned

Jan 16, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Robert J Tillges, CPO, FAAOP

Title

Owner/President

Phone

(651) 772-2665

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Tillges Certified Orthotic Prosthetic, Inc.

  • Prosthetic/Orthotic Supplier
  • Woodbury, MN
  • NPI 1275599706

  5496873036

  Same PAC ID
• Tillges Certified Orthotic Prosthetic, Inc.

  • Prosthetic/Orthotic Supplier
  • Maplewood, MN
  • NPI 1568428092

  5496873036

  Same PAC ID
• Tillges Certified Orthotic Prosthetic, Inc.

  • Prosthetic/Orthotic Supplier
  • Coon Rapids, MN
  • NPI 1598576613

  5496873036

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389830400000",
    "number": "1700208337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 BEAM AVE",
            "address_2": "SUITE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091166",
            "telephone_number": "651-772-2665",
            "fax_number": "651-771-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 PORTLAND AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554041145",
            "telephone_number": "612-341-3660",
            "fax_number": "612-341-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TILLGES CERTIFIED ORTHOTIC PROSTHETIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-01-16",
        "status": "A",
        "authorized_official_last_name": "TILLGES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "651-772-2665",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO, FAAOP"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1018417",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "102162",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2G045TI",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78026500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "21446",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41783200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "8200377",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Efrah Tifow
• Najma Abdi Tifow
• Christopher James Tignanelli, MD
• Jacob Laurence Tigner, MD
• Kim Tillemans, DO
• Nicole Marie Tillman
• Julie Tilsen, M.A., LP
• Jessica Carny Tilton, RD
• Joshua Timberlake
• Jake Timian

• Prosthetic/Orthotic Supplier in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Prosthetic/Orthotic Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.