Carol Tillman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT8639 Issued in CA

Practice address

7117 Brockton Ave
Riverside, CA 92506-2615

Phone

(951) 782-5131

Fax

(951) 784-3258

NPI assigned

Dec 1, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Riverside Medical Clinic, Inc

  dba Riverside Medical Clinic

  • Dermatology Physician
  • Riverside, CA
  • NPI 1720183403
  Medicare reassignment Care Compare group NPD
• Riverside Medical Clinic, Inc

  dba Riverside Medical Clinic

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1730180415

  Optometrist

  NPD

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1770567919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062658",
            "telephone_number": "951-782-5131",
            "fax_number": "951-784-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062615",
            "telephone_number": "951-782-5131",
            "fax_number": "951-784-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "CAROL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT8639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOUP NPI",
            "identifier": "1730180415",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry Ticey, RN
• Neide Tichy, MSW
• Desiree Michelle Tiet
• Kevin Tijerina
• Indira Tillett, RBT
• John Tillman
• Shelby Layne Tillotson I
• Roger Sheldon Tilton, PH.D.
• Teresa Timms, NP
• Dale J Timothy, RPH

• Optometrist in Riverside, CA
• Providers in Riverside, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.
• 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.