Sandra Tate, APN, PMHNP-BC is a medicare enrolled "Clinical Nurse Specialist - Psychiatric/mental Health, Child & Adolescent" in Marion, Illinois. Her current practice location is
3412 Office Park Dr, Marion, Illinois. You can reach out to her office (for appointments etc.) via phone at
(618) 292-9999.
Sandra Tate is licensed to practice in Illinois (license number 277000849) 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 1326093493.
Provider's Profile
| Full Name | Sandra Tate |
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| Gender | Female |
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| Speciality | Clinical Nurse Specialist - Psychiatric/mental Health, Child & Adolescent |
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| Location | 3412 Office Park Dr, Marion, Illinois |
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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: 1326093493
- Provider Enumeration Date: 05/24/2006
- Last Update Date: 11/20/2025
Medicare PECOS Information:
- PECOS PAC ID: 3577518455
- Enrollment ID: I20050314000599
Medical Identifiers
Medical identifiers for Sandra Tate such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1326093493 | NPI | - | NPPES |
| CG2264 | Other | IL | RR GROUP NUMBER |
| 207988 | Other | IL | GROUP |
| P00220754 | Other | IL | RR MEDICARE NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 364SP0807X | Clinical Nurse Specialist - Psychiatric/mental Health, Child & Adolescent | 277000849 (Illinois) | Primary |
| 363L00000X | Nurse Practitioner | 277.000849 (Illinois) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 277.000849 (Illinois) | Secondary |
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. Sandra Tate allows following entities to bill medicare on her behalf.
| Entity Name | Salem Township Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295739548
PECOS PAC ID: 0840195277
Enrollment ID: O20031126000688 |
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| Entity Name | Washington County Hospital District |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659321560
PECOS PAC ID: 4880599844
Enrollment ID: O20031209000278 |
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| Entity Name | Marshall Browning Hospital Association |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1821099441
PECOS PAC ID: 9335049980
Enrollment ID: O20040226000868 |
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| Entity Name | Community Resource Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1386605434
PECOS PAC ID: 8224050638
Enrollment ID: O20051229000256 |
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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. Sandra Tate 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 |
|---|
Sandra Tate, APN, PMHNP-BC
Po Box 155,
Christopher, IL 62822-0155
Ph: (618) 724-2401 | Sandra Tate, APN, PMHNP-BC
3412 Office Park Dr,
Marion, IL 62959-6477
Ph: (618) 292-9999 |
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