Tiffany Gullord, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Fairmont, Minnesota. Her current practice location is
800 Medical Center Dr, Fairmont, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(507) 238-8100.
Tiffany Gullord is licensed to practice in Minnesota (license number 20666) 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 1881313526.
Healthcare Provider's Profile
Full Name | Tiffany Gullord |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 800 Medical Center Dr, Fairmont, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1881313526
- Provider Enumeration Date: 08/25/2022
- Last Update Date: 09/23/2022
Medicare PECOS Information:
- PECOS PAC ID: 9931585387
- Enrollment ID: I20221007001990
Medical Identifiers
Medical identifiers for Tiffany Gullord such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1881313526 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 20666 (Minnesota) | 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. Tiffany Gullord allows following entities to bill medicare on her behalf.
Entity Name | Mayo Clinic Health System-southwest Minnesota Region |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1578545422 PECOS PAC ID: 4688585771 Enrollment ID: O20031110000134 |
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Entity Name | Mayo Clinic Health System-fairmont |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1366410862 PECOS PAC ID: 4981694981 Enrollment ID: O20040719000142 |
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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. Tiffany Gullord 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 |
Tiffany Gullord, LICSW 800 Medical Center Dr, Fairmont, MN 56031-4575 Ph: (507) 238-8100 | Tiffany Gullord, LICSW 800 Medical Center Dr, Fairmont, MN 56031-4575 Ph: (507) 238-8100 |
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