NPIMap

Individual provider Active NPI

Maria Tillman, M.D.

  • Emergency Medicine Physician
  • Woodruff, WI
National Provider Identifier
1992967673
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.144397 Issued in OH
Practice address
240 Maple St
Woodruff, WI 54568-9190
Phone
(715) 356-8000
NPI assigned
Jun 25, 2008
Last updated
Apr 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 002999 GA
Emergency Medicine Physician 207P00000X 35.144397 OH Primary

Addresses

Primary practice location

240 Maple St
Woodruff, WI 54568-9190

Mailing address

240 Maple St
Woodruff, WI 54568-9190
Phone (715) 356-8000

Other practice location 1

1120 15th Street
Medical College of Georgia, Emergency Medicine
Augusta, GA 30912-0006
Phone (706) 721-4951

Other practice location 2

601 State Route 664 N
Logan, OH 43138-8541
Phone (740) 380-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130325000536 WI Practitioner - Emergency Medicine 2961687827 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

240 Maple St
Woodruff, WI 54568-9190
Phone (715) 356-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.2 of 100Reported as group
Quality
84.08
Promoting interoperability
100
Improvement activities
40
Cost
64.31

Merit-based Incentive Payment System (MIPS)

Final score
86.59 of 100Reported as group
Quality
80.64
Promoting interoperability
100
Improvement activities
40
Cost
74.66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002999GAMDEmergency Medicine Physician
35.144397OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Mar 1, 2022 Accepting new patients
The Howard Young Medical Center, Inc. Emergency Medicine CurrentSince Feb 4, 2014 Accepting new patients
Aspirus Eagle River Hospital & Clinics, Inc. CurrentSince Feb 4, 2014 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Mar 1, 2022 Accepting new patients
Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin Emergency Medicine CurrentSince Aug 14, 2024 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Aug 14, 2024 Accepting new patients
Aspirus Eagle River Hospital, Inc. Emergency Medicine CurrentSince Feb 4, 2014 Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin Current Accepting new patients
Southern Wisconsin Emergency Associates SC Emergency Medicine Past Accepting new patients
Hastings Emergency Physicians PLC Emergency Medicine Past Accepting new patients
Ogeechee Valley Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

112 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2331

201 Hospital Rd
Eagle River, WI 54521
Phone (715) 477-3000

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Organizations & group practices 11

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.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1992967673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 MAPLE ST",
            "city": "WOODRUFF",
            "state": "WI",
            "postal_code": "545689190",
            "telephone_number": "715-356-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MAPLE ST",
            "city": "WOODRUFF",
            "state": "WI",
            "postal_code": "545689190",
            "telephone_number": "715-356-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 15th Street",
            "address_2": "Medical College of Georgia, Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309120006",
            "country_code": "US",
            "telephone_number": "706-721-4951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 State Route 664 N",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "OH",
            "postal_code": "431388541",
            "country_code": "US",
            "telephone_number": "740-380-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "002999",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.144397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodruff, WI

Sources for this page

Verify at the official NPI Registry.