Individual provider Active NPI

Nicholas M. Till, CRNA

  • Certified Registered Nurse Anesthetist
  • Springfield, IL
National Provider Identifier
1770729469
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209007476 Issued in IL
Practice address
1025 S 6TH St
Springfield, IL 62703-2403
Phone
(217) 528-7541
NPI assigned
Dec 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041335503 IL
Certified Registered Nurse Anesthetist 367500000X 209007476 IL Primary

Addresses

Primary practice location

1025 S 6TH St
Springfield, IL 62703-2403

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090309000439 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486710993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
041335503ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic, LLP CurrentSince Feb 2, 2015 Accepting new patients
Sangamon Associated Anesthesiologists, S.C. Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

800 E Carpenter St
#2334
Springfield, IL 62769
Phone (217) 525-5643

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

800 E Carpenter St
Rm 2K
Springfield, IL 62769
Phone (217) 525-5643

1025 S 6th St
Springfield, IL 62703

800 E Carpenter St
Rm 2334
Springfield, IL 62769
Phone (217) 525-5643

Interoperability endpoints

  • Direct secure messaging: nicholas.till.1@28977.direct.athenahealth.com

Organizations & group practices 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421712000000",
    "number": "1770729469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILL",
        "first_name": "NICHOLAS",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-30",
        "last_updated": "2015-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041335503",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209007476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.