NPIMap

Individual provider Active NPI

Edward Dail Tillett, MD

  • Orthopaedic Surgery Physician
  • Louisville, KY
National Provider Identifier
1700838703
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
22228 Issued in KY
Practice address
201 Abraham Flexner Way
Suite 100
Louisville, KY 40202
Phone
(502) 587-8222
Fax
(502) 587-0860
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 22228 KY Primary

Addresses

Primary practice location

201 Abraham Flexner Way
Suite 100
Louisville, KY 40202

Mailing address

6801 Dixie Hwy
Ste 130
Louisville, KY 40258-3913
Phone (502) 587-7222

Other identifiers 11

IdentifierTypeStateIssuer
0773853OtherKYMEDICARE-UNSPECIFIED
64222284MedicaidKY
000000049351OtherKYANTHEM/UNIV ORTHO ASSOC
100374040MedicaidKY
1049630OtherKYPASSPORT/UNIV ORTHO ASSOC
1071560OtherKYPASSPORT / R G SHEA
4043364OtherKYAETNA / R G SHEA
200013351OtherKYRAILROAD MEDICARE / R G SHEA
2434923000OtherKYPASSPORT ADVANTAGE / R G SHEA
000000048044OtherKYANTHEM / R G SHEA
2432607000OtherKYPASSPORT ADV/UNIV ORTHO A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090203000019 KY Practitioner - Orthopedic Surgery 0042123390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Louisville School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Louisville Physicians IncGroup PAC ID 3476725599, 1,438 clinicians
Cora Health Services IncGroup PAC ID 1759290992, shared by 21 NPIs, 1,125 clinicians
PT Pros, IncGroup PAC ID 0143139337, shared by 14 NPIs, 263 clinicians

Practice addresses (Care Compare)

201 Abraham Flexner Way
Suite 1200
Louisville, KY 40202-3481
Phone (502) 583-8383

2953 Traverse TRL
The Villages, FL 32163-2017
Phone (352) 693-3378

4031 N Dixie Hwy
Suite 104
Elizabethtown, KY 42701-7873
Phone (270) 982-4776

Hospital & facility affiliations

  • Vna Health at Home Home health agency, Louisville, KY, CCN 187000
  • UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040
  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22228KYMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. Orthopaedic Surgery Current Accepting new patients
Raymond G Shea MD PSC Orthopaedic Surgery Past Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients
University Physicians Group - Radiology Past Accepting new patients
University Orthopaedic Departmental Entity Inc Orthopaedic Surgery Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

201 Abraham Flexner Way
Ste 100
Louisville, KY 40202
Phone (502) 587-8222

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

550 S Jackson St
Fl First
Louisville, KY 40202
Phone (502) 852-0011

201 Abraham Flexner Way
Ste 1200
Louisville, KY 40202
Phone (502) 583-8383

550 S Jackson St
Fl 3
Louisville, KY 40202
Phone (502) 561-8850

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

530 S Jackson St
#1
Louisville, KY 40202
Phone (502) 852-7628

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

210 E Gray St
Ste 900
Louisville, KY 40202
Phone (502) 584-8002

Interoperability endpoints

  • Direct secure messaging: etillett14052@uoflhealth-dm.org

Organizations & group practices 7

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.

Hospital & facility affiliations 37

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1700838703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 DIXIE HWY",
            "address_2": "STE 130",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402583913",
            "telephone_number": "502-587-7222",
            "fax_number": "502-587-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 ABRAHAM FLEXNER WAY",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40202",
            "telephone_number": "502-587-8222",
            "fax_number": "502-587-0860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLETT",
        "first_name": "EDWARD",
        "middle_name": "DAIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": "22228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-UNSPECIFIED",
            "identifier": "0773853",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64222284",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM/UNIV ORTHO ASSOC",
            "identifier": "000000049351",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100374040",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT/UNIV ORTHO ASSOC",
            "identifier": "1049630",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT / R G SHEA",
            "identifier": "1071560",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA / R G SHEA",
            "identifier": "4043364",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE / R G SHEA",
            "identifier": "200013351",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE / R G SHEA",
            "identifier": "2434923000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM / R G SHEA",
            "identifier": "000000048044",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADV/UNIV ORTHO A",
            "identifier": "2432607000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.