Jay Tillman, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Canton, Connecticut. His current practice location is
50 Albany Turnpike, Canton Gateway Office Park #16, Canton, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(860) 693-8037.
Jay Tillman is licensed to practice in Connecticut (license number 038679) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497774384.
Physician's Profile
Full Name | Jay Tillman |
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Gender | Male |
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Speciality | Psychiatry & Neurology - Psychiatry |
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Location | 50 Albany Turnpike, Canton, Connecticut |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1497774384
- Provider Enumeration Date: 07/19/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 9133145675
- Enrollment ID: I20051024000614
Medical Identifiers
Medical identifiers for Jay Tillman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1497774384 | NPI | - | NPPES |
01003867979CT02 | Other | CT | BCBS |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2084P0800X | Psychiatry & Neurology - Psychiatry | 038679 (Connecticut) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jay Tillman allows following entities to bill medicare on his behalf.
Entity Name | Hartford Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1407806391 PECOS PAC ID: 2567366016 Enrollment ID: O20031125000700 |
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Entity Name | Hartford Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1770696643 PECOS PAC ID: 2567366016 Enrollment ID: O20031125000752 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jay Tillman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jay Tillman, MD 10 Fielding Woods, West Granby, CT 06090 Ph: (860) 693-8037 | Jay Tillman, MD 50 Albany Turnpike, Canton Gateway Office Park #16, Canton, CT 06019 Ph: (860) 693-8037 |
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