DAVID J TILSTRA MD NPI 1316928351

NPI Information

NPI: 1316928351
Provider Name: DAVID J TILSTRA, MD
Classification: Medical Genetics - 207SG0201X
Entity Type: Individual

Specialization: Clinical Genetics (M.D.)

PECOS Registration: Yes

Address:
1900 CENTRACARE CIR
SAINT CLOUD, MN
ZIP 56303
Phone: (320) 654-3630
Get Directions

David J Tilstra, MD is a clinical genetics (m.d.) medical genetics in Saint Cloud, MN with 36 years of experience. The provider is a clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. David J Tilstra, MD NPI is 1316928351. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Graduation Year:1988

The provider's business location address is:

1900 CENTRACARE CIR
SAINT CLOUD, MN
ZIP 56303-000
Phone: (320) 654-3630
Fax: (320) 654-3657

The NPI 1316928351 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/8/2005 and was last updated on 12/13/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		37920	MINNESOTA	No
2	207SG0201X	Medical Genetics	Clinical Genetics (M.D.)	37920	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier Issuer
1	1008055	OTHER	PREFERRED ONE
2	HP25528	OTHER	HEALTH PARTNERS
3	7713350	OTHER	SOUTH DAKOTA MA
4	110417	OTHER	UCARE
5	370001385	MEDICARE ID-TYPE UNSPECIFIED
6	074814500	OTHER	MEDICAL ASSISTANCE
7	2089340	OTHER	FIRST HEALTH PLAN
8	763003	OTHER	ARAZ GROUP AMERICAS PPO
9	1200086	OTHER	MEDICA HEALTH PLANS
10	51A44TI	OTHER	BLUE CROSS BLUE SHIELD
11	G01924	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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