DR. JUSTIN ULIP TILAN MD
NPI 1790195824
Orthopaedic Surgery - Orthopaedic Trauma in Saint Louis, MO

Q: What is Justin Tilan's NPI number?

The NPI number for Justin Tilan is 1790195824. It was assigned to this individual provider in the NPPES registry on April 29, 2014.

Q: What is Justin Tilan's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Trauma, with taxonomy code 207XX0801X.

Q: When was this NPI record last updated?

The NPPES record for Justin Tilan was last updated on November 30, 2021. 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 April 29, 2014PECOS EnrolledAccepts Medicare Assignment

4921 PARKVIEW PL, STE 6A/6B/12A, SAINT LOUIS, MO 63110(314) 747-2500(314) 747-2598 Get Directions Write a Review

NPPES record last updated: November 30, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 30, 2021, Oct 31, 2017, Aug 24, 2016 (3 updates tracked since 2016).

On this page

About Dr. Justin Ulip Tilan Md NPPES

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

DR. JUSTIN ULIP TILAN MD (NPI 1790195824) is an individual orthopaedic trauma provider in Saint Louis, Missouri, licensed in Missouri (2017010648) and active in the NPI registry since April 2014. He is enrolled in Medicare PECOS and is a graduate of University Of California, Irvine, California College Of Medicine (2012).

NPPES Registry Identity

NPI1790195824

Entity TypeIndividualMale

Primary Taxonomy207XX0801X

Provider Legal NameDR. JUSTIN ULIP TILANCredential: MD

Location Address4921 PARKVIEW PL, STE 6A/6B/12ASaint Louis, MO 63110-1032

Mailing Address660 S Euclid Ave, C B 8233Saint Louis, MO 63110-1010 · (314) 747-2500 · Fax (314) 747-2598

Phone(314) 747-2500

Fax(314) 747-2598

Sole ProprietorNo

Medical School CMSUniversity Of California, Irvine, California College Of MedicineGraduated 2012

Enumeration DateApril 29, 2014

Last NPPES UpdateNovember 30, 20213 updates tracked since enumeration

✔ NPI 1790195824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic TraumaAllopathic & Osteopathic Physicians

Taxonomy Code207XX0801X

License✔ Licensed in MO · 2017010648

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis.

4921 PARKVIEW PL, Saint Louis, MO 63110

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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

Dr. Justin Ulip Tilan 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 ID7517254469

PECOS Enrollment IDI20160921001310

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 Reassignment

Medicare enrollment records show Justin Tilan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Southern California Permanente Medical Group

1,555 mi

Health Maintenance Organization

4647 ZION AVE
San Diego, CA 92120

Reassigned Medicare billing, California enrollment
13,921 clinicians in this Medicare group

NPI 1225060742 (619) 528-5000

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

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.

DR. CHARLES PHILLIPS JONES MD

Urology

4921 PARKVIEW PL, DIV SURG UROLOGY, STE 11C
SAINT LOUIS, MO 63110

St. Louis City (314) 362-8200

DR. PRABHA RANGANATHAN MD

Internal Medicine (Rheumatology)

4921 PARKVIEW PL, DIV IM RHEUMATOLOGY, STE 5C
SAINT LOUIS, MO 63110

St. Louis City (314) 286-2635

DR. RALPH GERARD DACEY JR. MD

Neurological Surgery

4921 PARKVIEW PL, DEPT NEUROLOGICAL SURGERY, STE 6B/6C
SAINT LOUIS, MO 63110

St. Louis City (314) 362-3577

DR. KRASIMIRA MIKHAILOVA MIKHOVA MD

Internal Medicine (Clinical Cardiac Electrophysiology)

4921 PARKVIEW PL, DIV IM CARDIOLOGY, STE 8B
SAINT LOUIS, MO 63110

St. Louis City (314) 362-1291

DR. JEE YOUNG HAN MD

Psychiatry & Neurology (Neurology)

4921 PARKVIEW PL, DIV NEUROLOGY AGING AND DEMENTIA, STE 6C
SAINT LOUIS, MO 63110

St. Louis City (314) 362-1408

MS. MAREN JORGENSEN OT

Occupational Therapist

4921 PARKVIEW PL, DEPT OCCUPATIONAL THERAPY, STE 6F
SAINT LOUIS, MO 63110

St. Louis City (314) 286-1669

DR. ADRIAN SHIFREN MD

Internal Medicine (Pulmonary Disease)

4921 PARKVIEW PL, DIV IM PULMONARY AND CCM, 8TH FL
SAINT LOUIS, MO 63110

St. Louis City (314) 454-8917

DR. MYRA L RUBIO MD

Internal Medicine

4921 PARKVIEW PL, STE 5A
SAINT LOUIS, MO 63110

St. Louis City (314) 747-5900

DR. PETER G TUTEUR MD

Internal Medicine (Pulmonary Disease)

4921 PARKVIEW PL, 8TH FLOOR
SAINT LOUIS, MO 63110

St. Louis City (314) 454-8917

DR. RAMASWAMY GOVINDAN MD

Internal Medicine (Medical Oncology)

4921 PARKVIEW PL, DIV IM MEDICAL ONCOLOGY, STE 7A, 7B, 7C
SAINT LOUIS, MO 63110

St. Louis City (800) 647-2098

DR. CAROLYN KAY MCCOURT MD

Obstetrics & Gynecology (Gynecologic Oncology)

4921 PARKVIEW PL, DIV OBGYN GYNECOLOGIC ONCOLOGY, STE 13C
SAINT LOUIS, MO 63110

St. Louis City (314) 362-3181

DR. ADEL BASSAM TABCHY MD

Internal Medicine (Medical Oncology)

4921 PARKVIEW PL, 7TH FLOOR
SAINT LOUIS, MO 63110

St. Louis City (314) 747-1171

DR. BRIAN ADAMS KELLY MD

Orthopaedic Surgery (Pediatric Orthopaedic Surgery)

4921 PARKVIEW PL, DEPT ORTHOPAEDIC SURGERY, STE 6A/6B/12A
SAINT LOUIS, MO 63110

St. Louis City (314) 514-3500

DR. NICHOLAS ANDREW PALLOTTA MD

Orthopaedic Surgery (Orthopaedic Surgery of the Spine)

4921 PARKVIEW PL, DEPT ORTHOPAEDIC SURGERY, STE 6A/6B/12A
SAINT LOUIS, MO 63110

St. Louis City (314) 514-3500

MS. LORNA C KAHN PT

Physical Therapist

4921 PARKVIEW PL, DEPT PHYSICAL THERAPY, STE 6F
SAINT LOUIS, MO 63110

St. Louis City (314) 286-1940

MS. BRENDA G GOTTER AUD

Audiologist

4921 PARKVIEW PL, DEPT OTOLARYNGOLOGY, STE 11A
SAINT LOUIS, MO 63110

St. Louis City (314) 362-7509

DR. KAN LIU MD

Internal Medicine (Cardiovascular Disease)

4921 PARKVIEW PL, DIV IM CARDIOLOGY, STE 8B
SAINT LOUIS, MO 63110

St. Louis City (314) 362-1291

DR. SINA A JASIM MD

Internal Medicine (Endocrinology, Diabetes & Metabolism)

4921 PARKVIEW PL, DIV IM ENDOCRINOLOGY, STE 5C
SAINT LOUIS, MO 63110

St. Louis City (314) 362-3500

MS. SUSAN ANNETTE WILLIAMS PA

Physician Assistant (Medical)

4921 PARKVIEW PL, DIV NEUROLOGY EPILEPSY, STE 6C
SAINT LOUIS, MO 63110

St. Louis City (314) 362-7845

MR. STEPHEN MATTHEW BROADDUS PA

Physician Assistant

4921 PARKVIEW PL, DEPT ORTHOPAEDIC SURGERY, STE 6A/6B/12A
SAINT LOUIS, MO 63110

St. Louis City (314) 514-3500

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 Justin Tilan's NPI number?

The NPI number for Justin Tilan is 1790195824. It was assigned to this individual provider in the NPPES registry on April 29, 2014.

Where is Justin Tilan located?

Justin Tilan practices at 4921 Parkview Pl Ste 6a/6b/12a, Saint Louis, MO 63110. The listed phone number is (314) 747-2500.

What is Justin Tilan's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Trauma, with taxonomy code 207XX0801X.

Is Justin Tilan enrolled in Medicare?

Yes. Justin Tilan 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.

Which organization bills Medicare for Justin Tilan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justin Tilan reassigns Medicare benefits to Southern California Permanente Medical Group (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Justin Tilan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Justin Tilan was last updated on November 30, 2021. 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.