Keith Tisdell, in Kyle, TX - Medicare Occupational Therapist Provider

Keith Tisdell, is a medicare enrolled "Occupational Therapist" provider in Kyle, Texas. His current practice location is 189 Decker, Kyle, Texas. You can reach out to his office (for appointments etc.) via phone at (954) 328-5436.

Keith Tisdell is licensed to practice in Florida (license number 113654) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1477550630.

Contact Information

	Keith Tisdell,
	189 Decker, Kyle, TX 78640-5791
	(954) 328-5436
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Keith Tisdell
Gender	Male
Speciality	Occupational Therapist
Location	189 Decker, Kyle, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1477550630
Provider Enumeration Date: 07/03/2005
Last Update Date: 01/11/2012

Medicare PECOS Information:

PECOS PAC ID: 6507396280
Enrollment ID: I20250211000921

Medical Identifiers

Medical identifiers for Keith Tisdell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477550630	NPI	-	NPPES
887054300	Medicaid	FL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	10016 (Florida)	Secondary
225X00000X	Occupational Therapist	113654 (Florida)	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. Keith Tisdell allows following entities to bill medicare on his behalf.

Provider Name	Legacy Healthcare Services Inc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1336535988 PECOS PAC ID: 2163339722 Enrollment ID: O20150805009289

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. Keith Tisdell 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
Keith Tisdell, 189 Decker, Kyle, TX 78640-5791 Ph: (954) 328-5436	Keith Tisdell, 189 Decker, Kyle, TX 78640-5791 Ph: (954) 328-5436

Reviews and Comments

Occupational Therapist in Kyle, TX

Ms. Nicole Anne Brodhead, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 407 S Old Highway 81, Kyle, TX 78640 Phone: 512-504-3035 Fax: 512-504-9287
Vachonna S Durall, OTR Occupational Therapist Medicare: Medicare Enrolled Practice Location: 4701 Ratcliffe Dr, Kyle, TX 78640 Phone: 512-920-6400
Loren Nicole Moses, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 407 S Old Highway 81, Kyle, TX 78640 Phone: 512-504-3035 Fax: 512-504-9287
Ms. Susan Jean Nickelson, OTRIL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 407 S Old Highway 81, Kyle, TX 78640 Phone: 512-504-3035 Fax: 512-504-9287
Stacy Rayann Bustos, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 132 Ashwood S, Kyle, TX 78640 Phone: 281-851-3086
Logan Long, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 5980 Kyle Pkwy, Kyle, TX 78640 Phone: 512-308-3015

Keith Tisdell, - Medicare Occupational Therapist in Kyle, TX