Individual provider Active NPI

Kelly Marie Tillotson, MD

  • Emergency Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1760001408
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2025011256 Issued in MO
Practice address
1 Barnes Jewish Hospital PLZ
Dept Emergency Med
Saint Louis, MO 63110-1003
Phone
(314) 362-9123
Fax
(314) 362-0478
NPI assigned
Apr 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2025011256 MO Primary

Addresses

Primary practice location

1 Barnes Jewish Hospital PLZ
Dept Emergency Med
Saint Louis, MO 63110-1003

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-9123

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240105004120 OH Practitioner - Emergency Medicine 4688093214 Reassigns benefits to 2 organizations
I20250708003906 MO Practitioner - Emergency Medicine 4688093214 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Wisconsin, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington University Community Specialists LLCGroup PAC ID 8628588514, 94 clinicians
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1225 Graham Rd
Florissant, MO 63031-8012
Phone (314) 362-9123

12634 Olive Blvd
Saint Louis, MO 63141-6337
Phone (314) 996-8470

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
65.97
Promoting interoperability
100
Improvement activities
40
Cost
74.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025011256MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jul 1, 2025 Accepting new patients
Washington University Community Specialists, LLC CurrentSince Jul 1, 2025 Accepting new patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Jan 1, 2024 Accepting new patients
Washington University CurrentSince Jul 1, 2025 Accepting new patients
University of Cincinnati Physicians Company, LLC CurrentSince Jul 1, 2024 Accepting new patients
University Surgical-Dental Associates, LLC Past Accepting new patients

Locations

1225 Graham Rd
#U
Florissant, MO 63031

1 Barnes Jewish Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-1700

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

660 S Euclid Ave
Saint Louis, MO 63110

12634 Olive Blvd
Saint Louis, MO 63141
Phone (314) 434-0600

3200 Burnet Ave
#2
Cincinnati, OH 45229
Phone (513) 585-5505

4777 E Galbraith Rd
Cincinnati, OH 45236
Phone (513) 686-3000

3200 Burnet Ave
Cincinnati, OH 45229
Phone (513) 558-7700

3199 Highland Ave
Cincinnati, OH 45219
Phone (513) 475-7777

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

231 Albert Sabin Way
Cincinnati, OH 45267
Phone (513) 558-6356

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

6939 Cox Rd
Liberty Township, OH 45069
Phone (513) 206-1460

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

230 Medical Center Dr
Seaman, OH 45679
Phone (937) 386-3400

Organizations & group practices 6

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1760001408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-9123",
            "fax_number": "314-362-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ",
            "address_2": "DEPT EMERGENCY MED",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-362-9123",
            "fax_number": "314-362-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLOTSON",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2025-07-16",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2025011256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Barnes Jewish Hospital Plz",
            "address_2": "Dept Emergency Med",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.