Mary Gwynne Tillotson, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

403249 Issued in NY

Practice address

621 10TH St
Niagara Falls, NY 14301-1813

Phone

(716) 278-4541

Fax

(716) 278-4544

NPI assigned

Oct 28, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Cohill Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Niagara Falls Memorial Medical CenterGroup PAC ID 0244134484, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Niagara Falls Memorial Medical Center Hospital, Niagara Falls, NY, CCN 330065
• Mount St. Mary's Hospital & Health Center Hospital, Lewiston, NY, CCN 330188

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/3c975af8-28ae-4d97-adec-66228015b5a8/

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.

• Niagara Falls Memorial Medical Center

  • General Acute Care Hospital
  • Niagara Falls, NY
  • NPI 1285717298
  Medicare reassignment Care Compare group NPD
• Niagara Falls Memorial Medical Center

  • Oncology Clinic/Center
  • Niagara Falls, NY
  • NPI 1144842816
  NPD

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

• Mount St. Mary's Hospital of Niagara Falls

  dba Mount St. Mary's Hospital and Health Center

  • General Acute Care Hospital
  • Lewiston, NY
  • NPI 1043394745
  Care Compare affiliation
• Niagara Falls Memorial Medical Center

  • General Acute Care Hospital
  • Niagara Falls, NY
  • NPI 1285717298
  Care Compare affiliation

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1780284869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 10TH ST",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011813",
            "telephone_number": "716-278-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 10TH ST",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143011813",
            "telephone_number": "716-278-4541",
            "fax_number": "716-278-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLOTSON",
        "first_name": "MARY",
        "middle_name": "GWYNNE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "403249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "COHILL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adam Christopher Thomas, DPT
• Heather Alice Thomson, PA
• Marlon Thornton, LMHC-P, CASAC
• Thrive Global LLC
• Tianfu Group LLC
• Gayle Diane Tilton, CSW-R
• Michael Tilton
• Tmo Medical, PC
• Nicole Marie Tobey, MSW
• William Charles Tompkins, RPH

• Psychiatric/Mental Health Nurse Practitioner in Niagara Falls, NY
• Providers in Niagara Falls, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.