Tisha Marie Larsen, - Medicare Registered Nurse in Roseburg, OR

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Tisha Marie Larsen, is a medicare enrolled "Registered Nurse - Psychiatric/mental Health, Adult" in Roseburg, Oregon. Her current practice location is 621 W Madrone St, Roseburg, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 440-3500.

Tisha Marie Larsen is licensed to practice in Oregon (license number 201910861NP-PP) 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 1578954855.

Contact Information

Tisha Marie Larsen,
621 W Madrone St,
Roseburg, OR 97470-3090
(541) 440-3500
(541) 957-3003

Map and Direction




Provider's Profile

Full NameTisha Marie Larsen
GenderFemale
SpecialityRegistered Nurse - Psychiatric/mental Health, Adult
Location621 W Madrone St, Roseburg, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1578954855
  • Provider Enumeration Date: 02/09/2015
  • Last Update Date: 10/12/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 2668791351
  • Enrollment ID: I20181105000870

Medical Identifiers

Medical identifiers for Tisha Marie Larsen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1578954855NPI-NPPES
165772MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 201500780NP-PP (Oregon)Secondary
163WP0809XRegistered Nurse - Psychiatric/mental Health, Adult 201910861NP-PP (Oregon)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. Tisha Marie Larsen allows following entities to bill medicare on her behalf.
Entity NameAdapt
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1720010549
PECOS PAC ID: 4587662887
Enrollment ID: O20061121000327

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. Tisha Marie Larsen 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
Tisha Marie Larsen,
Po Box 1121,
Roseburg, OR 97470-0254

Ph: (541) 672-2691		Tisha Marie Larsen,
621 W Madrone St,
Roseburg, OR 97470-3090

Ph: (541) 440-3500

Reviews and Comments


Registered Nurse Nurses in Roseburg, OR

Catherine Joyce Paul, RN
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 621 W Madrone St, Roseburg, OR 97470
Phone: 541-440-3571    Fax: 541-957-3704
Mr. Fredrick Ryan Wilkins, RN
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 913 Garden Valley Blvd, Roseburg, OR 97471
Phone: 541-440-1000    Fax: 541-677-3189
Erin P Cassidy, FNP
Registered Nurse
Medicare: Accepting Medicare Assignments
Practice Location: 780 Nw Garden Valley Blvd Ste 310, Roseburg, OR 97471
Phone: 541-640-7625    
Melissa Heselius, RN
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 913 Nw Garden Valley Blvd, Roseburg, OR 97471
Phone: 541-440-1000    
Shelli Cross,
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 2700 Nw Stewart Pkwy, Roseburg, OR 97471
Phone: 541-677-4845    
Brittney Gardner,
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 548 Se Jackson St, Roseburg, OR 97470
Phone: 541-440-3532    
Jacqueline Jill Fummerton, RN
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 621 W Madrone St, Roseburg, OR 97470
Phone: 541-440-3639    Fax: 541-957-3704

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.