Mimi Tyson, - Medicare Nurse Practitioner in North Bethesda, MD

Mimi Tyson, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in North Bethesda, Maryland. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. Her current practice location is 11810 Grand Park Ave Ste 500, North Bethesda, Maryland. You can reach out to her office (for appointments etc.) via phone at (030) 139-2712.

Mimi Tyson is licensed to practice in Virginia (license number 0024177697) 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 1952960924.

Contact Information

Mimi Tyson,
11810 Grand Park Ave Ste 500,
North Bethesda, MD 20852-8679
(030) 139-2712
Not Available

Map and Direction




Provider's Profile

Full NameMimi Tyson
GenderFemale
SpecialityNurse Practitioner
Experience5 Years
Location11810 Grand Park Ave Ste 500, North Bethesda, Maryland
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mimi Tyson graduated from nursing school in 2019
  NPI Data:
  • NPI Number: 1952960924
  • Provider Enumeration Date: 06/12/2019
  • Last Update Date: 04/24/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2567790470
  • Enrollment ID: I20190829002568

Medical Identifiers

Medical identifiers for Mimi Tyson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1952960924NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health R180111 (Maryland)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 0024177697 (Virginia)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. Mimi Tyson allows following entities to bill medicare on her behalf.
Entity NameNeuropsych Wellness Center, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588977748
PECOS PAC ID: 9335271725
Enrollment ID: O20100721000168
Entity NameCervello-wellness Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083239255
PECOS PAC ID: 5890118004
Enrollment ID: O20200707001485

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. Mimi Tyson 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
Mimi Tyson,
4014 Diamondhead Ave,
Bowie, MD 20721-1308

Ph: (301) 828-5239
Mimi Tyson,
11810 Grand Park Ave Ste 500,
North Bethesda, MD 20852-8679

Ph: (030) 139-2712

Reviews and Comments


Nurse Practitioner Nurses in North Bethesda, MD

Jessica Durkin Morgan, NP
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Leigh Anna Cole, MSN, APRN, FNP-C
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Practice Location: 11870 Grand Park Ave Apt 902, North Bethesda, MD 20852
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Christine Cernoch, CRNP
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Practice Location: 11801 Rockville Pike Apt 1604, North Bethesda, MD 20852
Phone: 301-642-0818    
Josephine Moore, FNP-BC
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Medicare: Medicare Enrolled
Practice Location: 11810 Grand Park Ave Ste 500, North Bethesda, MD 20852
Phone: 240-856-1393    
Beth Renne, ANP-BC
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Medicare: Not Enrolled in Medicare
Practice Location: 6000 Executive Blvd, Suite 304, North Bethesda, MD 20852
Phone: 240-221-0000    Fax: 240-221-0441
Jennifer C Clayton, NP
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Medicare: Medicare Enrolled
Practice Location: 6278 Montrose Rd, North Bethesda, MD 20852
Phone: 240-535-6339    

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).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.