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ANDREA TILLOTSON
NPI 1396532065
Nurse Practitioner - Family in Salt Lake City, UT

Active since April 24, 2025PECOS Enrolled
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113(801) 487-0451 Get Directions Write a Review

NPPES record last updated: December 16, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 16, 2025, Dec 1, 2025, Sep 3, 2025 and 1 more (4 updates tracked since 2025).

About Andrea Tillotson NPPES

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

ANDREA TILLOTSON (NPI 1396532065) is an individual family provider in Salt Lake City, Utah, licensed in Utah (6203483-4405) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1396532065
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameANDREA TILLOTSON
Location Address100 N MARIO CAPECCHI DRSalt Lake City, UT 84113-1103
Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128
Phone(801) 487-0451
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateApril 24, 2025
Last NPPES UpdateDecember 16, 20254 updates tracked since enumeration
NPPES CertifiedDecember 16, 2025
✔ NPI 1396532065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 6203483-4405
100 N MARIO CAPECCHI DR, Salt Lake City, UT 84113
Open in Google Maps ↗

Other Names 1

Former Name (1)Andrea Druk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrea Tillotson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9032611678
PECOS Enrollment IDI20250904000989
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 84113 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
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.

KEEGAN MARIE RYAN PT, DPT
Physical Therapist
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-4980
IHC HEALTH SERVICES INC
Pediatrics
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
MADELINE ANN THAYER NP
Nurse Practitioner (Family)
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-3600
DR. JEFFREY S PRINCE MD
Radiology (Diagnostic Radiology)
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 487-0451
MICHELLE PLOUTZ
Pediatrics (Pediatric Cardiology)
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
ALICIA DONALDSON APRN
Nurse Practitioner (Pediatrics, Critical Care)
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
HANNAH MARIE WINEBAUM MS, OTR/L
Occupational Therapist
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
MARK EDWARD HAMAKER M.D.
Pediatrics (Pediatric Endocrinology)
100 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 587-3922

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 Andrea Tillotson's NPI number?

The NPI number for Andrea Tillotson is 1396532065. It was assigned to this individual provider in the NPPES registry on April 24, 2025. The provider is also known as Andrea Druk.

Where is Andrea Tillotson located?

Andrea Tillotson practices at 100 N Mario Capecchi Dr, Salt Lake City, UT 84113. The listed phone number is (801) 487-0451.

What is Andrea Tillotson's specialty?

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

Is Andrea Tillotson enrolled in Medicare?

Yes. Andrea Tillotson is registered in the Medicare PECOS enrollment system.

What insurance does Andrea Tillotson accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Utah list Andrea 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.

When was this NPI record last updated?

The NPPES record for Andrea Tillotson was last updated on December 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.