T'juaniequa Wideman, AGACNP-BC - Medicare Nurse Practitioner in Tyler, TX

T'juaniequa Wideman, AGACNP-BC is a medicare enrolled "Nurse Practitioner" in Tyler, Texas. Her current practice location is 800 E Dawson St, Tyler, Texas. You can reach out to her office (for appointments etc.) via phone at (903) 593-8441.

T'juaniequa Wideman is licensed to practice in Texas (license number 1115976) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1053195982.

Contact Information

T'juaniequa Wideman, AGACNP-BC
800 E Dawson St,
Tyler, TX 75701-2036
(903) 593-8441
Not Available

Map and Direction




Provider's Profile

Full NameT'juaniequa Wideman
GenderFemale
SpecialityNurse Practitioner
Location800 E Dawson St, Tyler, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1053195982
  • Provider Enumeration Date: 08/22/2023
  • Last Update Date: 09/22/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3274988449
  • Enrollment ID: I20231006003276

Medical Identifiers

Medical identifiers for T'juaniequa Wideman such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053195982NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LG0600XNurse Practitioner - Gerontology 1115976 (Texas)Secondary
363L00000XNurse Practitioner 1115976 (Texas)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. T'juaniequa Wideman allows following entities to bill medicare on her behalf.
Entity NameChristus Trinity Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285684225
PECOS PAC ID: 3072426741
Enrollment ID: O20031204001091

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. T'juaniequa Wideman 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 AddressPractice Location Address
T'juaniequa Wideman, AGACNP-BC
1309 S Azalea Dr,
Tyler, TX 75701-5222

Ph: (903) 520-4873
T'juaniequa Wideman, AGACNP-BC
800 E Dawson St,
Tyler, TX 75701-2036

Ph: (903) 593-8441

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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