DR. BRIAN TILLIS MD
NPI 1396107405
Obstetrics & Gynecology in Pleasant Prairie, WI

Q: What is Brian Tillis's NPI number?

The NPI number for Brian Tillis is 1396107405. It was assigned to this individual provider in the NPPES registry on March 28, 2016.

Q: What is Brian Tillis's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Brian Tillis was last updated on July 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 March 28, 2016PECOS EnrolledAccepts Medicare Assignment

79.61/100

CMS Quality Rating

9555 76TH ST STE 4105, PLEASANT PRAIRIE, WI 53158(262) 577-8080(262) 577-8081 Get Directions Write a Review

NPPES record last updated: July 16, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 16, 2020, Mar 28, 2016 (2 updates tracked since 2016).

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About Dr. Brian Tillis Md NPPES

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

DR. BRIAN TILLIS MD (NPI 1396107405) is an individual obstetrics & gynecology provider in Pleasant Prairie, Wisconsin, licensed in Wisconsin (69543-20) and active in the NPI registry since March 2016. He is enrolled in Medicare PECOS, is affiliated with Froedtert South Inc., and is a graduate of Southern Illinois University School Of Medicine (2016).

NPPES Registry Identity

NPI1396107405

Entity TypeIndividualMale

Primary Taxonomy207V00000X

Provider Legal NameDR. BRIAN TILLISCredential: MD

Location Address9555 76TH ST STE 4105Pleasant Prairie, WI 53158-1984

Mailing Address9555 76th St # 4105Pleasant Prairie, WI 53158-1984 · (262) 577-8080 · Fax (262) 577-8081

Phone(262) 577-8080

Fax(262) 577-8081

Sole ProprietorNo

Medical School CMSSouthern Illinois University School Of MedicineGraduated 2016

Enumeration DateMarch 28, 2016

Last NPPES UpdateJuly 16, 20202 updates tracked since enumeration

NPPES CertifiedJuly 16, 2020

✔ NPI 1396107405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in WI · 69543-20

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

9555 76TH ST STE 4105, Pleasant Prairie, WI 53158

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Other Identifiers 1

Other69543-20WI · Wi License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health.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

Dr. Brian Tillis Md 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 ID2365781473

PECOS Enrollment IDI20200722003812

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

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 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.

14 services11 patients

Hospital Affiliations CMS Care Compare

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

Froedtert South Inc.

Acute Care Hospitals · Pleasant Prairie, WI

1/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number520021

Location9555 76th StPleasant Prairie, WI 53158 · Kenosha County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53158 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.61/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

70.88

Promoting Interoperability

100

Improvement Activities

Cost

61.15

Other Providers at the Same Location NPPES 2

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

THOMAS M AMBRO MD

Obstetrics & Gynecology

9555 76TH ST STE 4105
PLEASANT PRAIRIE, WI 53158

Kenosha County (262) 577-8080

BRITTANY FREDERICK APNP

Nurse Practitioner (Obstetrics & Gynecology)

9555 76TH ST STE 4105
PLEASANT PRAIRIE, WI 53158

Kenosha County (262) 577-8080

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 Brian Tillis's NPI number?

The NPI number for Brian Tillis is 1396107405. It was assigned to this individual provider in the NPPES registry on March 28, 2016.

Where is Brian Tillis located?

Brian Tillis practices at 9555 76th St Ste 4105, Pleasant Prairie, WI 53158. The listed phone number is (262) 577-8080.

What is Brian Tillis's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Brian Tillis enrolled in Medicare?

Yes. Brian Tillis 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 Brian Tillis accept?

Health plans from Anthem Blue Cross and Blue Shield and Network Health list Brian Tillis 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 Brian Tillis affiliated with any hospitals?

According to CMS data, Brian Tillis is affiliated with Froedtert South Inc..

When was this NPI record last updated?

The NPPES record for Brian Tillis was last updated on July 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.