Allison Tillack, MD, PHD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

MD60940915 Issued in WA

Practice address

801 S Stevens St
Spokane, WA 99204-2654

Phone

(509) 363-7788

NPI assigned

Apr 9, 2014

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 WA, MT, OR3 enrollments

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 3

Specialty

Diagnostic Radiology

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia County Hospital DistrictGroup PAC ID 5597653758, 55 clinicians

The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Inland Imaging Associates PSGroup PAC ID 7810327210, 124 clinicians

The Corvallis Clinic P CGroup PAC ID 1456244540, 128 clinicians

Oregon Healthcare Resources LLCGroup PAC ID 4486835477, 160 clinicians

Integra Imaging PSGroup PAC ID 1355593062, 126 clinicians

Inland Imaging LLCGroup PAC ID 6608763016, 128 clinicians

Moses Lake Community Health CenterGroup PAC ID 1254235138, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
• Summit Pacific Medical Center Hospital, Elma, WA, CCN 501304
• Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002
• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054
• St. Patrick Hospital Hospital, Missoula, MT, CCN 270014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4

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.

• Columbia County Hospital District

  • Critical Access Hospital
  • Dayton, WA
  • NPI 1134128911
  Medicare reassignment Care Compare group NPD
• Inland Imaging Associates PS

  • Diagnostic Radiology Physician
  • Seattle, WA
  • NPI 1982236469

  MT

  Medicare reassignment Care Compare group NPD
• Inland Imaging LLC

  • Diagnostic Radiology Physician
  • Spokane, WA
  • NPI 1851352348

  MT

  Medicare reassignment Care Compare group NPD
• Integra Imaging, PS

  • Diagnostic Radiology Physician
  • Spokane, WA
  • NPI 1205189461

  MT

  Medicare reassignment Care Compare group NPD
• Moses Lake Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Moses Lake, WA
  • NPI 1699862813
  Medicare reassignment Care Compare group NPD
• The Polyclinic PLLC

  • Audiologist
  • Seattle, WA
  • NPI 1174594634
  Medicare reassignment Care Compare group NPD
• Oregon Healthcare Resources, LLC

  • Multi-Specialty Clinic/Center
  • Eugene, OR
  • NPI 1982907572

  WA

  Medicare reassignment Care Compare group NPD
• The Corvallis Clinic P C

  • Multi-Specialty Clinic/Center
  • Corvallis, OR
  • NPI 1649227265

  WA

  Medicare reassignment Care Compare group NPD
• Grant County Public Hospital District 2

  • Emergency Medical Services (Emergency Medicine) Physician
  • Quincy, WA
  • NPI 1659445468
  Medicare reassignment NPD
• Grant County Public Hospital District 3

  • Emergency Medical Services (Emergency Medicine) Physician
  • Ephrata, WA
  • NPI 1134283930
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1205942257
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1356305395
  Medicare reassignment NPD

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

• Grays Harbor County Public Hospital District No 1

  • Critical Access Hospital
  • Elma, WA
  • NPI 1740211028
  Care Compare affiliation
• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580
  Care Compare affiliation
• Providence Health & Services - Wa

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation
• Providence Health & Services - Washington

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  Care Compare affiliation
• Providence Health & Services Mt

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1023032588
  Care Compare affiliation
• Providence Health & Services Mt

  • Medical Oncology Physician
  • Missoula, MT
  • NPI 1326483587

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Anatomic Pathology & Clinical Pathology Physician
  • Missoula, MT
  • NPI 1366185928

  Hospital

  Care Compare affiliation
• Providence Health & Services Mt

  • Psychiatric Hospital Unit
  • Missoula, MT
  • NPI 1619058302
  Care Compare affiliation

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1821417544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S STEVENS ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042654",
            "telephone_number": "509-363-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S STEVENS ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042654",
            "telephone_number": "509-363-7788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 Broadway",
            "address_2": "Suite WW-739",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981224379",
            "country_code": "US",
            "telephone_number": "206-386-2123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLACK",
        "first_name": "ALLISON",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60940915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1821417544",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Dale Tichenor-Brown, CRNA
• Sandra L Tidwell, ARNP
• Stefanie Eleanna Tietge, BSW
• Kiira M Tietjen, DNP ARNP PMHNP
• Brandie Nichole Tilch-Bryant, ARNP-DNP-FNP
• Rebecca L Tiller, MA, LMHC
• Justin Owen Tillery, LMFTA
• Kassie May Tillson
• Samantha Jo Tilson, ARNP, FNP-C
• Timberview Inc

• Diagnostic Radiology Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Diagnostic Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.