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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 Enrolled
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: August 09, 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.

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
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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Chanel T. Tillery Dnp, Aprn, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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 enrollment system.

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 22 months 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.