MR. CHARLES R JR. TILLEY – Physician Assistant, NPI 1467502286
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,648 PHYSICIAN ASSISTANT in IA
Provider Addresses for MR. CHARLES R JR. TILLEY
180 10TH ST SE STE 201
LE MARS, IA 510312557
Phone: (712) 546-4624
Fax: (712) 546-9395
Type: Location
County Road HH, Town of Wolf River, Winnebago County, Wisconsin, 54940, United States
WINNEBAGO, NE 680710767
Phone: (402) 878-2231
Fax: (402) 878-2236
Type: Mailing
PO BOX 70
LE MARS, IA 510310070
Phone: (712) 546-4624
Fax: (712) 546-9395
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 100 Open Payments records for all available years, with a total value of $1,161.
Total Amount is formed as General ($1,161) + Research ($0) + Ownership ($0) = $1,161.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ABBVIE INC. ($407).
Total Amount
$1,161
General + Research + Ownership
Payments
100
Total payment records
General Amount
$1,161
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
| Company | Amount |
|---|---|
| ABBVIE INC. | $407 |
| Otsuka America Pharmaceutical, Inc. | $220 |
| Janssen Pharmaceuticals, Inc | $110 |
| Alkermes, Inc. | $97 |
| Teva Pharmaceuticals USA, Inc. | $50 |
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: 2007-02-09
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 |
|---|---|---|---|---|
| I20070209000497 | I | Physician Assistant | IA | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 355 | 207 | $0 |
| Q3014 | Telehealth originating site facility fee | 87 | 63 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 34 | 33 | $0 |
Insurance plans in this area (ZIP 51031)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | NE | 90833 | Psychotherapy, 30 minutes with patient and/or family member | 107 | 53 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Radiology | SD | |
| Nurse Practitioner | IA | |
| Nurse Practitioner | IA | |
| P S Y C H I A T R Y | CO | |
| A N E S T H E S I O L O G Y | FL | |
| Internal Medicine | IA | |
| Emergency Medicine | IA | |
| - | IA | |
| Pulmonary Disease, Internal Medicine | TX | |
| Critical Care (Intensivists), Internal Medicine, Pulmonary Disease | IA |
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