KATHERINE TILLEM (PA-C) – Physician Assistant, NPI 1780239889
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
4,431 PHYSICIAN ASSISTANT in GA
Provider Addresses for KATHERINE TILLEM (PA-C)
209 COOLEY DR STE 101
VILLA RICA, GA 301807057
Phone: (770) 456-0911
Type: Location
Georgian Park, Peachtree City, Fayette County, Georgia, 30290, United States
PEACHTREE CITY, GA 30269
Phone:
Type: Mailing
8901 STONEBRIDGE BLVD STE 200
DOUGLASVILLE, GA 301342254
Phone: (943) 202-7120
Fax: (470) 986-7087
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 36 Open Payments records for all available years, with a total value of $932.
Total Amount is formed as General ($932) + Research ($0) + Ownership ($0) = $932.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ABBVIE INC. ($360).
Total Amount
$932
General + Research + Ownership
Payments
36
Total payment records
General Amount
$932
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-05-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200509000121 | I | Physician Assistant | GA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 68 | 11 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 61 | 53 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 54 | 27 | $0 |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 40 | 38 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 21 | 16 | $0 |
Insurance plans in this area (ZIP 30180)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| - | GA | |
| - | GA | |
| R H E U M A T O L O G Y | MI | |
| Hospitalist, Internal Medicine | GA | |
| Nurse Practitioner | TN | |
| Family Practice | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| Hospitalist, Internal Medicine | GA |
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