ETHAN TILLOTSON M.D.
NPI 1194175273
Family Medicine in Tupelo, MS

Q: What is Ethan Tillotson's NPI number?

The NPI number for Ethan Tillotson is 1194175273. It was assigned to this individual provider in the NPPES registry on June 20, 2016.

Q: What is Ethan Tillotson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Tillotson was last updated on June 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 20, 2016PECOS EnrolledAccepts Medicare Assignment

1665 S GREEN ST, TUPELO, MS 38804(662) 377-2189 Get Directions Write a Review

NPPES record last updated: June 20, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Ethan Tillotson M.d. NPPES

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

ETHAN TILLOTSON M.D. (NPI 1194175273) is an individual family medicine provider in Tupelo, Mississippi, licensed in Mississippi (25270) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with North Mississippi Medical Center, and is a graduate of University Of Mississippi School Of Medicine (2016).

NPPES Registry Identity

NPI1194175273

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameETHAN TILLOTSONCredential: M.D.

Location Address1665 S GREEN STTupelo, MS 38804-6556

Mailing Address1665 S Green StTupelo, MS 38804-6556 · (662) 377-2189

Phone(662) 377-2189

Sole ProprietorNo

Medical School CMSUniversity Of Mississippi School Of MedicineGraduated 2016

Enumeration DateJune 20, 2016

Last NPPES UpdateJune 20, 2022

NPPES CertifiedJune 20, 2022

✔ NPI 1194175273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MS · 25270

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1665 S GREEN ST, Tupelo, MS 38804

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Molina Healthcare.Insurance ›

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

Ethan Tillotson M.d. 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 ID8224323183

PECOS Enrollment IDI20200526003086

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

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

North Mississippi Faculty Practice Plan LLC

Same address

Family Medicine

1665 S GREEN ST
Tupelo, MS 38804

Reassigned Medicare billing, Mississippi enrollment
11 clinicians in this Medicare group

NPI 1255692356 (662) 377-2189

Clay County Medical Corporation

33 mi

Surgery

502 S CHESTNUT ST
Aberdeen, MS 39730

Reassigned Medicare billing, Mississippi enrollment
101 clinicians in this Medicare group

NPI 1831728633 (662) 319-8844

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

Areas of Expertise CMS Part B claims 21

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

164 services125 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

152 services117 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

117 services97 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

60 services55 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

58 services48 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

52 services47 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

51 services42 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

50 services27 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

47 services30 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

44 services42 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

26 services26 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

25 services22 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

22 services22 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

19 services16 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

18 services18 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

17 services16 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

15 services15 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

15 services15 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

14 services14 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

14 services14 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

14 services14 patients

Hospital Affiliations CMS Care Compare

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

North Mississippi Medical Center

Acute Care Hospitals · Tupelo, MS

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number250004

Location830 S Gloster StreetTupelo, MS 38801 · Lee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38804 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513

DME-Other DME · category DE000N

2 suppliers11 claims11 services$26.02 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

YONG SEOK CHANG DO

Student in an Organized Health Care Education/Training Program