Alan C. Tillis, M.D.

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

25MA02117500 Issued in NJ

Practice address

1 Oskar CT
Livingston, NJ 07039-8236

Phone

(973) 992-0538

Fax

(973) 992-1333

NPI assigned

May 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750593356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OSKAR CT",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070398236",
            "telephone_number": "973-992-0538",
            "fax_number": "973-992-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OSKAR CT",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070398236",
            "telephone_number": "973-992-0538",
            "fax_number": "973-992-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLIS",
        "first_name": "ALAN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MA02117500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valeska Thompson
• Arianna Leigh Thomson, P.A.
• Tian Xia MD PA
• Kim Nguyen Tibaldi, M.D.
• Huey Chung Tien, MD
• Tina M. Petillo DO PA
• Matthew Joseph Tinnirella
• Tiny Voices Big Words, LLC
• TMJ & Sleep Therapy Centre of Metropolitan New Jersey
• Christie Tolerico, PT

• Pediatric Orthopaedic Surgery Physician in Livingston, NJ
• Providers in Livingston, NJ by specialty
• Pediatric Orthopaedic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.