Tilmer O. Engebretson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810003165 Issued in VA

Practice address

7927 Jones Branch Dr
Suite #6125
MC Lean, VA 22102-3322

Phone

(571) 633-0600

Fax

(703) 992-0993

NPI assigned

Jan 4, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2017 through Jul 1, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Central Ohio Behavioral Medicine Inc

  • Clinical Social Worker
  • Columbus, OH
  • NPI 1508936204
  NPD (past)

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1780869149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7927 JONES BRANCH DR",
            "address_2": "SUITE #6125",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023322",
            "telephone_number": "571-633-0600",
            "fax_number": "703-992-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7927 JONES BRANCH DR",
            "address_2": "SUITE #6125",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023322",
            "telephone_number": "571-633-0600",
            "fax_number": "703-992-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGEBRETSON",
        "first_name": "TILMER",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-04",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003165",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "VA",
            "license": "0810003165",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "VA",
            "license": "0810003165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emerging Vision Inc
• Alexandra Emile
• Empire Hearing Incorporated
• En Sante Clinic & Medical Spa PLLC
• Engebretson Psychology, LLC
• Cassandra Lucia Enriquez, LP
• Herman Ensey
• Envisioncare Health Services
• Tracie Epes, M.S., ED.S., LPC
• Pallavi Epuri

• Clinical Psychologist in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.