Individual provider Active NPI

Niral Harry Tilala, MD

  • Family Medicine Physician
  • Davenport, IA
National Provider Identifier
1780884551
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R8225 Issued in IA
Practice address
1345 W Central Park Ave
Davenport, IA 52804-1844
Phone
(563) 421-4400
Fax
(563) 421-4449
NPI assigned
Jul 20, 2007
Last updated
Apr 20, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R8225 IA Primary

Addresses

Primary practice location

1345 W Central Park Ave
Davenport, IA 52804-1844

Mailing address

1345 W Central Park Ave
Davenport, IA 52804-1844
Phone (563) 421-4400

Other practice location 1

413 S Mississippi St
Blue Grass, IA 52726-9127
Phone (563) 381-2180

Electronic endpoints 3

TypeEndpointUseAffiliation
Other URL CCDA Direct
Direct Messaging Address niral.tilala@direct.genesishealth.com Direct
Other URL niral.tilala@direct.genesishealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080104000180 IA Practitioner - Family Practice 6709966682 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Genesis Health SystemGroup PAC ID 7214841436, 217 clinicians

Practice addresses (Care Compare)

1227 E Rusholme St
Davenport, IA 52803-2459

1345 W Central Park Ave
Mercyone Genesis Family Medical Cen
Davenport, IA 52804-1844
Phone (563) 421-4400

619 5TH St
Durant, IA 52747-7737
Phone (563) 785-4487

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R8225IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Waverly Health Center CurrentSince Dec 1, 2025 Accepting new patients
Mercy Specialty Clinic Family Medicine CurrentSince Feb 1, 2023 Accepting new patients
Mercy Specialty Clinic CurrentSince Feb 1, 2023 Accepting new patients
Grinnell Regional Medical Center Family Medicine CurrentSince Apr 15, 2026 Accepting new patients
Waverly Health Center CurrentSince Dec 1, 2025 Accepting new patients
Genesis Health System Family Medicine CurrentSince Jul 6, 2010 Accepting new patients
Waverly Health Center Family Medicine CurrentSince Dec 13, 2025 Accepting new patients
Genesis Health System CurrentSince Jul 6, 2010 Accepting new patients
Medical Associates of Clinton, Iowa P.L.C. Family Medicine Current Accepting new patients
Genesis Health System Family Medicine Past Accepting new patients
Genesis Health System Past Accepting new patients
Genesis Health System Family Medicine PastSince Aug 4, 2025 Accepting new patients
Genesis Medical Education Foundation Inc Family Medicine Past Accepting new patients
Genesis Health System Family Medicine Past Accepting new patients
Genesis Health System Past Accepting new patients

Locations

915 13th Ave N
Clinton, IA 52732
Phone (319) 243-2511

1345 W Central Park Ave
Davenport, IA 52804
Phone (563) 421-4400

1351 W Central Park Ave
Ste 340
Davenport, IA 52804
Phone (563) 421-1287

210 W 53rd St
Davenport, IA 52806
Phone (563) 386-3436

619 5th St
Durant, IA 52747
Phone (563) 785-4487

202 4th Ave
Fl 2
Grinnell, IA 50112
Phone (641) 236-2925

312 9th St SW
Waverly, IA 50677
Phone (319) 352-4120

Interoperability endpoints

  • Direct secure messaging: niral.tilala@direct.genesishealth.com
  • Direct secure messaging: ntilala4515635@direct.trinity-health.org

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 3

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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1780884551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041844",
            "telephone_number": "563-421-4400",
            "fax_number": "563-421-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041844",
            "telephone_number": "563-421-4400",
            "fax_number": "563-421-4449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 S Mississippi St",
            "address_purpose": "LOCATION",
            "city": "Blue Grass",
            "state": "IA",
            "postal_code": "527269127",
            "country_code": "US",
            "telephone_number": "563-381-2180",
            "fax_number": "563-381-2182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILALA",
        "first_name": "NIRAL",
        "middle_name": "HARRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R8225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "CCDA",
            "affiliation": "N",
            "endpointDescription": "Genesis Health System Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1345 W Central Park Ave",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528041844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "niral.tilala@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "genesis health system direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1345 W Central Park Ave",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528041844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "niral.tilala@direct.genesishealth.com",
            "affiliation": "N",
            "endpointDescription": "genesis health system direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1345 W Central Park Ave",
            "city": "Davenport",
            "state": "IA",
            "country_code": "US",
            "postal_code": "528041844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.