Mrs Rebekah June Tisdale, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Waddington, New York. Her current practice location is
4 Montgomery Heights, Waddington, New York. You can reach out to her office (for appointments etc.) via phone at
(315) 388-7872.
Mrs Rebekah June Tisdale is licensed to practice in New York (license number 354223) 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 1295566388.
Provider's Profile
| Full Name | Mrs Rebekah June Tisdale |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 4 Montgomery Heights, Waddington, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1295566388
- Provider Enumeration Date: 08/09/2024
- Last Update Date: 11/27/2024
Medicare PECOS Information:
- PECOS PAC ID: 9335679265
- Enrollment ID: I20250207001305
Medical Identifiers
Medical identifiers for Mrs Rebekah June Tisdale such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1295566388 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 354223 (New York) | 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. Mrs Rebekah June Tisdale allows following entities to bill medicare on her behalf.
| Entity Name | Carthage Area Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053497388
PECOS PAC ID: 9931010485
Enrollment ID: O20040209000856 |
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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. Mrs Rebekah June Tisdale 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 |
|---|
Mrs Rebekah June Tisdale, FNP-BC
4 Montgomery Heights,
Waddington, NY 13694
Ph: (315) 388-7872 | Mrs Rebekah June Tisdale, FNP-BC
4 Montgomery Heights,
Waddington, NY 13694
Ph: (315) 388-7872 |
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