Dr Ronald Coury Tisdale, MD is a medicare enrolled "Family Medicine" provider in Selma, Alabama. He went to Icahn School Of Medicine At Mount Sinai and graduated in 2017 and has 7 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Paragon Contracting Services Llc, Ies Alabama Pllc and his current practice location is
1023 Medical Center Pkwy, Selma, Alabama. You can reach out to his office (for appointments etc.) via phone at
(650) 387-2272.
Dr Ronald Coury Tisdale is licensed to practice in Alabama (license number MD.41401) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1790203461.
Healthcare Provider's Profile
Full Name | Dr Ronald Coury Tisdale |
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Gender | Male |
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Speciality | Family Practice |
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Experience | 7 Years |
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Location | 1023 Medical Center Pkwy, Selma, Alabama |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Ronald Coury Tisdale attended and graduated from Icahn School Of Medicine At Mount Sinai in 2017
NPI Data:
- NPI Number: 1790203461
- Provider Enumeration Date: 09/01/2017
- Last Update Date: 09/02/2020
Medicare PECOS Information:
- PECOS PAC ID: 6901138445
- Enrollment ID: I20210219000344
Medical Identifiers
Medical identifiers for Dr Ronald Coury Tisdale such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1790203461 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
207P00000X | Emergency Medicine | MD.41401 (Alabama) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | MD.41401 (Alabama) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Paragon Contracting Services Llc | 3971417825 | 266 |
Ies Alabama Pllc | 5395105183 | 28 |
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. Dr Ronald Coury Tisdale allows following entities to bill medicare on his behalf.
Entity Name | University Of Alabama At Birmingham |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1184738478 PECOS PAC ID: 3779487970 Enrollment ID: O20031120000323 |
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Entity Name | Paragon Contracting Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1225071459 PECOS PAC ID: 3971417825 Enrollment ID: O20050218000756 |
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Entity Name | Emergency Services Of Montgomery Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1528310323 PECOS PAC ID: 6608028204 Enrollment ID: O20121205000519 |
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Entity Name | Lakeland Physicians, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1851780951 PECOS PAC ID: 0446578298 Enrollment ID: O20150408000559 |
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Entity Name | Ies Alabama Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1053027276 PECOS PAC ID: 5395105183 Enrollment ID: O20230712000361 |
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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. Dr Ronald Coury 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 |
Dr Ronald Coury Tisdale, MD 625 19th St S, Birmingham, AL 35233-1900 Ph: (650) 387-2272 | Dr Ronald Coury Tisdale, MD 1023 Medical Center Pkwy, Selma, AL 36701-6750 Ph: (650) 387-2272 |
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