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DR. CHANEL T. TILLERY DNP, APRN, FNP-C
NPI 1083463657
Nurse Practitioner - Family in Newark, NJ

Active since May 16, 2024PECOS EnrolledAccepts Medicare Assignment
150 BERGEN ST, NEWARK, NJ 07103(973) 972-5123 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 19, 2024, May 16, 2024 (2 updates tracked since 2024).

About Dr. Chanel T. Tillery Dnp, Aprn, Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CHANEL T. TILLERY DNP, APRN, FNP-C (NPI 1083463657) is an individual family provider in Newark, New Jersey, licensed in New Jersey (26NJ15148700) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS, is affiliated with The University Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1083463657
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDR. CHANEL T. TILLERYCredential: DNP, APRN, FNP-C
Location Address150 BERGEN STNewark, NJ 07103-2496
Mailing Address150 Bergen StNewark, NJ 07103-2496 · (973) 972-5123
Phone(973) 972-5123
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateMay 16, 2024
Last NPPES UpdateSeptember 19, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 1, 2024
✔ NPI 1083463657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NJ · 26NJ15148700
Also ListedRegistered NurseTaxonomy 163W00000X · License 26NR20372200 (NJ)
150 BERGEN ST, Newark, NJ 07103
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Chanel T. Tillery Dnp, Aprn, Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2163959305
PECOS Enrollment IDI20250327003422
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Chanel Tillery reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Hospital
Same address
Acute Care
150 BERGEN STREET, DEPTPARTMENT OF EMERGENCY ROOM M-219
Newark, NJ 07101
  • Reassigned Medicare billing, New Jersey enrollment
  • 55 clinicians in this Medicare group
NPI 1023266962 (973) 972-1193
Your Neighborhood Clinic LLC
6.9 mi
Primary Care
454 MORRIS AVE
Springfield, NJ 07081
  • Reassigned Medicare billing, New Jersey enrollment
  • 3 clinicians in this Medicare group
NPI 1407424021 (908) 312-0288

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

The University Hospital

Acute Care Hospitals · Newark, NJ
1/5 CMS rating
OwnershipGovernment - State
CMS Certification Number310119
Location150 Bergen StNewark, NJ 07103 · Essex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. ARIEL LIPPA, LPC, LCADC, NCC.
Counselor (Professional)
150 BERGEN ST
NEWARK, NJ 07103
Essex County (973) 972-4300
GABRIEL HANNA
Student in an Organized Health Care Education/Training Program
150 BERGEN ST
NEWARK, NJ 07103
Essex County (201) 397-5249
ADRIANA NOEMI GONZALEZ MD
Emergency Medicine
150 BERGEN ST
NEWARK, NJ 07103
Essex County (973) 972-4300
DR. SAFIA ANSARI DO
Student in an Organized Health Care Education/Training Program
150 BERGEN ST
NEWARK, NJ 07103
Essex County (973) 972-4300
MERRY ZHAI MD
Student in an Organized Health Care Education/Training Program
150 BERGEN ST
NEWARK, NJ 07103
Essex County (973) 972-4300
HEATHER WANG
Student in an Organized Health Care Education/Training Program
150 BERGEN ST
NEWARK, NJ 07103
Essex County (973) 972-4300
KOPAL BANSAL MD
Student in an Organized Health Care Education/Training Program
150 BERGEN ST
NEWARK, NJ 07103
Essex County (973) 972-4300
ADRIENNE-VYOLET BALK MD
Student in an Organized Health Care Education/Training Program
150 BERGEN ST
NEWARK, NJ 07103
Essex County (973) 972-4300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Chanel Tillery's NPI number?

The NPI number for Chanel Tillery is 1083463657. It was assigned to this individual provider in the NPPES registry on May 16, 2024.

Where is Chanel Tillery located?

Chanel Tillery practices at 150 Bergen St, Newark, NJ 07103. The listed phone number is (973) 972-5123.

What is Chanel Tillery's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Chanel Tillery enrolled in Medicare?

Yes. Chanel Tillery is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Chanel Tillery's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Chanel Tillery reassigns Medicare benefits to 2 organizations: University Hospital (Newark, NJ) and Your Neighborhood Clinic LLC (Springfield, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Chanel Tillery's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Chanel Tillery affiliated with any hospitals?

According to CMS data, Chanel Tillery is affiliated with The University Hospital.

When was this NPI record last updated?

The NPPES record for Chanel Tillery was last updated on September 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.