Individual provider Active NPI

Macy D Thilker, FNP

  • Family Nurse Practitioner
  • Troy, IL
National Provider Identifier
1770344798
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
208.028953 Issued in IL
Practice address
619 Edwardsville Rd
Troy, IL 62294-1441
Phone
(618) 667-1200
NPI assigned
Jan 17, 2024
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 208.028953 IL Primary

Addresses

Primary practice location

619 Edwardsville Rd
Troy, IL 62294-1441

Mailing address

619 Edwardsville Rd
Troy, IL 62294-1441
Phone (618) 667-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241216003228 IL Practitioner - Nurse Practitioner 1254867138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Ahs Il Medical Group LLCGroup PAC ID 5496111676, 46 clinicians

Practice addresses (Care Compare)

619 Edwardsville Rd
Troy, IL 62294-1441
Phone (618) 667-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
208.028953ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Il Medical Group LLC CurrentSince Sep 15, 2024 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

4273 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-2297

2100 Madison Ave
Ste 301
Granite City, IL 62040

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

619 Edwardsville Rd
Troy, IL 62294
Phone (618) 667-1200

Interoperability endpoints

  • Direct secure messaging: macy.thilker.1@28328.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1770344798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 EDWARDSVILLE RD",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622941441",
            "telephone_number": "618-667-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 EDWARDSVILLE RD",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622941441",
            "telephone_number": "618-667-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THILKER",
        "first_name": "MACY",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "208.028953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, IL

Sources for this page

Verify at the official NPI Registry.