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

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: July 26, 2026.

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
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

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

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

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.

Student in an Organized Health Care Education/Training Program
1665 S GREEN ST
TUPELO, MS 38804
Student in an Organized Health Care Education/Training Program
1665 S GREEN ST
TUPELO, MS 38804
Family Medicine
1665 S GREEN ST
TUPELO, MS 38804
Student in an Organized Health Care Education/Training Program
1665 S GREEN ST
TUPELO, MS 38804
Student in an Organized Health Care Education/Training Program
1665 S GREEN ST
TUPELO, MS 38804
Student in an Organized Health Care Education/Training Program
1665 S GREEN ST
TUPELO, MS 38804
Family Medicine
1665 S GREEN ST
TUPELO, MS 38804
Student in an Organized Health Care Education/Training Program
1665 S GREEN ST
TUPELO, MS 38804

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 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.

Where is Ethan Tillotson located?

Ethan Tillotson practices at 1665 S Green St, Tupelo, MS 38804. The listed phone number is (662) 377-2189.

What is Ethan Tillotson's specialty?

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

Is Ethan Tillotson enrolled in Medicare?

Yes. Ethan Tillotson 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.

What insurance does Ethan Tillotson accept?

Health plans from Blue Cross and Blue Shield of Alabama, Molina Healthcare and UnitedHealthcare list Ethan Tillotson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ethan Tillotson affiliated with any hospitals?

According to CMS data, Ethan Tillotson is affiliated with North Mississippi Medical Center.

When was this NPI record last updated?

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