MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC) – Clinical Social Worker, NPI 1528380623

MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC) is a healthcare provider. based in Lansing, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MBA, LMSW, ICAADC. They hold a License No. C-02622 (MI). The NPI Number for MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC) is 1528380623

Main info

Male
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC)
NPI
1528380623
Phone
(517) 515-6176
Address
3721 W MICHIGAN AVE STE 200
Enumeration Date
17 February 2010
Last Update Date
13 September 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5175156176
Graduation Year
2014 (12 years ago)
PAC ID
7214294974
Group Practice PAC ID
1355854209
Professional Enrollment ID
I20171205002052
Address ID
MI489173600LA3721XAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience70
Completeness75
Years active:16State licenses:2Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

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Provider Addresses for MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC)

  • West Michigan Avenue, Downtown, Lansing, Ingham County, Michigan, 48933, United States

    LANSING, MI 489173600

    Phone: (517) 515-6176

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2017-12-05

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171205002052IClinical Social WorkerMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48917)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355854209View full group profile
NameSpecialtyState
Clinical Social WorkerMI

Reviews

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Frequently asked questions

What identifier follows MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC) across health systems?
The NPI 1528380623 uniquely identifies MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC) in U.S. healthcare data.
Is MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC) currently accepting referrals based on NPI status?
Registry metadata lists MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC) as active.
Which specialty label fits MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC)?
NPPES ties MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC) to Clinical Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC)?
MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC) shows a connection to Lansing, Michigan in registry-derived data.
Can I export MR. RICARDO DAVID TILLERY (MBA, LMSW, ICAADC)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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