Tiffany Gullord, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Fairmont, Minnesota. She graduated from medical school in 2012 and has 14 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Mayo Clinic Health System-southwest Minnesota Region and her current practice location is
800 Medical Center Dr, Fairmont, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(507) 238-8100.
Tiffany Gullord is licensed to practice in Minnesota (license number 20666) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1881313526.
Healthcare Provider's Profile
| Full Name | Tiffany Gullord |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 14 Years |
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| Location | 800 Medical Center Dr, Fairmont, Minnesota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Tiffany Gullord graduated from medical school in 2012
NPI Data:
- NPI Number: 1881313526
- Provider Enumeration Date: 08/25/2022
- Last Update Date: 09/23/2022
Medicare PECOS Information:
- PECOS PAC ID: 9931585387
- Enrollment ID: I20221007001990
Medical Identifiers
Medical identifiers for Tiffany Gullord such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1881313526 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | 20666 (Minnesota) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Mayo Clinic Health System-southwest Minnesota Region | 4688585771 | 605 |
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. Tiffany Gullord allows following entities to bill medicare on her behalf.
| Entity Name | Mayo Clinic Health System-southwest Minnesota Region |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1578545422 PECOS PAC ID: 4688585771 Enrollment ID: O20031110000134 |
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| Entity Name | Mayo Clinic Health System-fairmont |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366410862 PECOS PAC ID: 4981694981 Enrollment ID: O20040719000142 |
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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. Tiffany Gullord 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 |
Tiffany Gullord, LICSW 800 Medical Center Dr, Fairmont, MN 56031-4575 Ph: (507) 238-8100 | Tiffany Gullord, LICSW 800 Medical Center Dr, Fairmont, MN 56031-4575 Ph: (507) 238-8100 |
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