KIMBERLY LYNN TILLER (PA-C) – Physician Assistant, NPI 1467930883
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for KIMBERLY LYNN TILLER (PA-C)
213 SUMMIT HILL DR
WOOD RIVER, IL 620954066
Phone: (951) 956-0253
Type: Mailing
4500 Memorial Dr
Belleville, IL 622265360
Phone: (618) 233-7750
Type: Location
Memorial Hospital, 4500, Memorial Drive, Royal Heights, Belleville, Saint Clair County, Illinois, 62226, United States
BELLEVILLE, IL 622265360
Phone: (618) 233-7750
Type: Location
2122 TROY RD STE 130
EDWARDSVILLE, IL 620252540
Phone: (618) 800-4500
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $278.
Total Amount is formed as General ($278) + Research ($0) + Ownership ($0) = $278.
Last reported payment date: 2024-10-31 • Largest payer in this snapshot: Lilly USA, LLC ($123).
Total Amount
$278
General + Research + Ownership
Payments
15
Total payment records
General Amount
$278
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $123 |
| Novo Nordisk Inc | $49 |
| Janssen Pharmaceuticals, Inc | $40 |
| ABBVIE INC. | $22 |
| Almatica Pharma LLC | $17 |
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: 2019-04-15
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 |
|---|---|---|---|---|
| I20190415002402 | I | Physician Assistant | IL | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 125 | 116 | $0 |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 56 | 55 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 48 | 48 | $0 |
| 87428 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza | 44 | 44 | $0 |
| 81002 | Urinalysis, manual test | 33 | 32 | $0 |
Insurance plans in this area (ZIP 62095)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Physician Assistant | IL | |
| Family Practice | IL | |
| - | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| G A S T R O E N T E R O L O G Y | GA | |
| Physician Assistant | IL | |
| - | MO | |
| Gastroenterology, Gastroenterology, Internal Medicine | OH |
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