MR. JACKSON E. TILLQUIST ARNP
NPI 1720442940
Nurse Practitioner in Safety Harbor, FL

NPI Status: Active since April 13, 2016

Contact Information

1840 MEASE DR
SUITE 200
SAFETY HARBOR, FL
ZIP 34695
Phone: (727) 724-8611
Fax: (727) 724-0425

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  • Individual
  • Male
  • Years of Experience 10
  • Nurse Practitioner
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JACKSON TILLQUIST

This page provides the complete NPI Profile along with additional information for Jackson Tillquist, a provider established in Safety Harbor, Florida with a medical specialization in Nurse Practitioner and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1720442940 assigned on April 2016. The practitioner's primary taxonomy code is 363L00000X with license number ARNP9258226 (FL). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1720442940
Provider Name
MR. JACKSON E. TILLQUIST ARNP
Gender
Male
Entity Type
Individual
Location Address
1840 MEASE DR SUITE 200 SAFETY HARBOR, FL 34695
Location Phone
(727) 724-8611
Location Fax
(727) 724-0425
Mailing Address
PO BOX 10744 CLEARWATER, FL 33757
Mailing Phone
(727) 532-0002
Mailing Fax
(727) 724-0425
Medical School Name
OTHER
Graduation Year
2016
Is Sole Proprietor?
No
Enumeration Date
04-13-2016
Last Update Date
10-14-2016
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A nurse practitioner (NP) like Jackson Tillquist is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner

Taxonomy Code
363L00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
ARNP9258226
License State
FL
Taxonomy Description
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1163WC0200XNursing Service Providers

Registered Nurse
Critical Care Medicine

9258226 (FL)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • AvMed Entrust Bronze 600 (2025) - HMO
  • AvMed Entrust Bronze 650 (2025) - HMO
  • AvMed Entrust Expanded Bronze Standard (2025) - HMO
  • AvMed Entrust Gold 125 (2025) - HMO
  • AvMed Entrust Gold 125 Dental+Vision (2025) - HMO
  • AvMed Entrust Gold Standard (2025) - HMO
  • AvMed Entrust Platinum 25 (2025) - HMO
  • AvMed Entrust Platinum 25 Dental+Vision (2025) - HMO
  • AvMed Entrust Platinum Standard (2025) - HMO
  • AvMed Entrust Silver 350 (2025) - HMO
  • AvMed Entrust Silver 350 Dental+Vision (2025) - HMO
  • AvMed Entrust Silver 550 (2025) - HMO
  • AvMed Entrust Silver 550 Dental+Vision (2025) - HMO
  • AvMed Entrust Silver Standard (2025) - HMO
  • Connect Bronze 0 Indiv Med Deductible - EPO
  • Connect Bronze 5500 Indiv Med Deductible - EPO
  • Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - EPO
  • Connect Bronze CMS Standard - EPO
  • Connect Gold 2000 Indiv Med Deductible - EPO
  • Connect Gold 800 Indiv Med Deductible - EPO
  • Connect Gold CMS Standard - EPO
  • Connect Silver 3600 Indiv Med Deductible - EPO
  • Connect Silver 4300 Indiv Med Deductible - EPO
  • Connect Silver CMS Standard - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
IS028YMEDICARE PIN (08)FL 
018482900MEDICAID (05)FL 
IS028ZMEDICARE PIN (08)FL 

Medicare Participation & PECOS Enrollment Status

Jackson Tillquist is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jackson Tillquist is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 4183912934

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20161011000384

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 123 times for 119 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 31 times for 30 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 33 times for 33 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.9 for a new patient copayment and $24.79 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 34695 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $87.62
  • Minimum New Patient Price $56
  • Maximum New Patient Price $171.84
  • Average New Patient Copayment $21.9
  • Minimum New Patient Copayment $14
  • Maximum New Patient Copayment $42.96

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.16
  • Minimum Established Patient Price $17.57
  • Maximum Established Patient Price $139.16
  • Average Established Patient Copayment $24.79
  • Minimum Established Patient Copayment $4.39
  • Maximum Established Patient Copayment $34.79

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jackson Tillquist is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
MORTON PLANT HOSPITAL300 PINELLAS ST
CLEARWATER, FL 33756
(727) 462-7000Acute Care Hospitals

Reviews for MR. JACKSON E. TILLQUIST ARNP

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1720442940
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
274084498
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 4 + 0 + 8 + 4 + 4 + 9 + 8 + 24 = 70
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1720442940 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1457359390DR. ROBERT JAY STEIN MD
Individual
Internal Medicine (Pulmonary Disease)1840 MEASE DR SUITE 307
SAFETY HARBOR, FL 34695
(727) 725-6128
1679556435 DEBORAH ADAMS NIKJEH
Individual
Speech-Language Pathologist1840 MEASE DR SUITE 403
SAFETY HARBOR, FL 34695
(727) 725-6241
1275592057DR. JOHN KLONARIS MD
Individual
Internal Medicine (Cardiovascular Disease)1840 MEASE DR SUITE 200
SAFETY HARBOR, FL 34695
(727) 724-8611
1851342885DR. KIMBERLY MILLER QUICK MD
Individual
Internal Medicine (Cardiovascular Disease)1840 MEASE DR #200
SAFETY HARBOR, FL 34695
(727) 724-8611
1639126642DR. MUHAMMAD H. FAROOQI M.D.
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)1840 MEASE DR SUITE 104
SAFETY HARBOR, FL 34695
(727) 725-6283
1598702821MRS. CYNTHY JOY DRUCKER R.D.
Individual
Dietitian, Registered1840 MEASE DR SUITE 104
SAFETY HARBOR, FL 34695
(727) 725-6283
1558300848MS. NANCY KANDER MAZA R.D.
Individual
Dietitian, Registered1840 MEASE DR SUITE 410
SAFETY HARBOR, FL 34695
(727) 734-6888
1497760102CENTER FOR BRAIN HEALTH INC
Organization
Clinical Neuropsychologist1840 MEASE DR SUITE 401A
SAFETY HARBOR, FL 34695
(727) 669-7000
1861585903 ARDESHIR KHADEMI-KERMANSHAHI MD
Individual
Psychiatry & Neurology (Neurology)1840 MEASE DR SUITE 407B
SAFETY HARBOR, FL 34695
(727) 712-1567
1588791099J. PAONESSA M.D. P.A.
Organization
Durable Medical Equipment & Medical Supplies1840 MEASE DR SUITE 309
SAFETY HARBOR, FL 34695
(727) 216-1141
1609074533DR. SUSAN JANE BOSTON M.D.
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)1840 MEASE DR SUITE 104
SAFETY HARBOR, FL 34695
(727) 725-6283
1689874976BAY UROLOGY PA
Organization
Urology1840 MEASE DR SUITE 403A
SAFETY HARBOR, FL 34695
(727) 449-2298
1770770240EZRA S ELKAYAM MD PA
Organization
Specialist1840 MEASE DR SUITE 315
SAFETY HARBOR, FL 34695
(727) 793-0663
1154518157WEST COAST AIDS FOUNDATION, INC
Organization
Case Management1840 MEASE DR SUITE 319
SAFETY HARBOR, FL 34695
(727) 669-6800
1619166469ARTHRITIS CARE CENTRE, LLC
Organization
Specialist1840 MEASE DR # 406
SAFETY HARBOR, FL 34695
(727) 669-4418
1710166384CLAUDINA A BONILLA MD FCCP PA
Organization
Internal Medicine (Pulmonary Disease)1840 MEASE DR SUITE # 405
SAFETY HARBOR, FL 34695
(727) 724-9395
1891958484SANTIAGO MORALES MD PA
Organization
Family Medicine (Adult Medicine)1840 MEASE DR SUITE 408
SAFETY HARBOR, FL 34695
(727) 791-7822
1902043847MRS. BRENNA HICKS M.A
Individual
Counselor (Professional)1840 MEASE DR 401A
SAFETY HARBOR, FL 34695
(727) 726-4598
1700012077 PATRICIA J FARRELL ARNP
Individual
Nurse Practitioner1840 MEASE DR SUITE 200
SAFETY HARBOR, FL 34695
(727) 724-8611
1063735926 IVETTE ELIZABETH BOLER ARNP
Individual
Registered Nurse (Oncology)1840 MEASE DR SUITE 309
SAFETY HARBOR, FL 34695
(727) 216-1141

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720442940, enumerated in the NPI registry as an "individual" on April 13, 2016

The provider is located at 1840 Mease Dr Suite 200 Safety Harbor, Fl 34695 and the phone number is (727) 724-8611

The provider's speciality is Nurse Practitioner with taxonomy code 363L00000X

The provider has more than 10 years of experience.

The provider might be accepting Accepts: AvMed, Cigna Healthcare, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $87.62 with an average copayment of $21.9 for new patient appointments. Established patients should expect a typical charge of $99.16 and an average copayment of 24.79. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 30-39 minutes, Established patient office or other outpatient visit, 40-54 minutes and Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report.

The practitioner is affiliated to the following hospital(s): MORTON PLANT HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on April 13, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.