Dr Tina Betty Ezeolisah, DNP, PMHNP-BC in Duluth, GA

Dr Tina Betty Ezeolisah, DNP, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Duluth, Georgia. Her current practice location is 3355 Mcdaniel Rd, Apt 17401, Duluth, Georgia. You can reach out to her office (for appointments etc.) via phone at (678) 704-3593.

Dr Tina Betty Ezeolisah is licensed to practice in Georgia (license number RN217223) 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 1306299268.

Contact Information

	Dr Tina Betty Ezeolisah, DNP, PMHNP-BC
	3355 Mcdaniel Rd, Apt 17401, Duluth, GA 30096-8613
	(678) 704-3593
	Not Available

Map and Direction

Provider's Profile

Full Name	Dr Tina Betty Ezeolisah
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	3355 Mcdaniel Rd, Duluth, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1306299268
Provider Enumeration Date: 07/15/2016
Last Update Date: 12/02/2022

Medicare PECOS Information:

PECOS PAC ID: 1850667957
Enrollment ID: I20171017002720

Medical Identifiers

Medical identifiers for Dr Tina Betty Ezeolisah such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1306299268	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	RN2345725 (Massachusetts)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	C-APN.0002066-C-NP (Colorado)	Secondary
163W00000X	Registered Nurse	RN 217223 (Georgia)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	05031 (Rhode Island)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	RN217223 (Georgia)	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. Dr Tina Betty Ezeolisah allows following entities to bill medicare on her behalf.

Entity Name	Highland Rivers Community Service Board
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447256243 PECOS PAC ID: 9032000245 Enrollment ID: O20040324001204

Entity Name	Personal Recovery Network Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881990869 PECOS PAC ID: 5092611384 Enrollment ID: O20120110000096

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. Dr Tina Betty Ezeolisah 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
Dr Tina Betty Ezeolisah, DNP, PMHNP-BC 1814 Clairmont Rd, Decatur, GA 30033-3405 Ph: (404) 636-1457	Dr Tina Betty Ezeolisah, DNP, PMHNP-BC 3355 Mcdaniel Rd, Apt 17401, Duluth, GA 30096-8613 Ph: (678) 704-3593

Reviews and Comments

Nurse Practitioner Nurses in Duluth, GA

Christopher Pride, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3350 Breckinridge Blvd Ste 200, Duluth, GA 30096 Phone: 720-472-8052
Mrs. Tujuana C Glenn Olajide, R.N., N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5404 Tree Summit Pkwy, Duluth, GA 30096 Phone: 678-477-3397 Fax: 678-417-9151
Ms. Isla Starr Marrero, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3075 Breckinridge Blvd, Suite 415, Duluth, GA 30096 Phone: 770-962-8396
Dailan Zhang, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3960 Howell Park Rd, Duluth, GA 30096 Phone: 404-324-0131
Lovelin Fonkika, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6650 Sugarloaf Pkwy Ste 800, Duluth, GA 30097 Phone: 404-921-3334
Ms. Jacqueline Hope Maureen Brown, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3510 Stoneham Dr, Duluth, GA 30097 Phone: 706-405-1703
Linda Lee Peabody, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3660 Howell Ferry Rd, Duluth, GA 30096 Phone: 770-670-4640

Dr Tina Betty Ezeolisah, DNP, PMHNP-BC - Medicare Nurse Practitioner in Duluth, GA