Dr Hollis Tidmore, MD is a medicare enrolled "Surgery" physician in Houston, Missouri. He went to University Of Mississippi School Of Medicine and graduated in 1980 and has 44 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Texas County Memorial Hospital and his current practice location is
1422 S Sam Houston Blvd, Houston, Missouri. You can reach out to his office (for appointments etc.) via phone at
(417) 967-1252.
Dr Hollis Tidmore is licensed to practice in Missouri (license number 2009005897) 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 1962473975.
Physician's Profile
| Full Name | Dr Hollis Tidmore |
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| Gender | Male |
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| Speciality | General Surgery |
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| Experience | 44 Years |
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| Location | 1422 S Sam Houston Blvd, Houston, Missouri |
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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. |
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Medical Education and Training:
- Dr Hollis Tidmore attended and graduated from University Of Mississippi School Of Medicine in 1980
NPI Data:
- NPI Number: 1962473975
- Provider Enumeration Date: 01/28/2006
- Last Update Date: 01/31/2023
Medicare PECOS Information:
- PECOS PAC ID: 3971536343
- Enrollment ID: I20090511000085
Medical Identifiers
Medical identifiers for Dr Hollis Tidmore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962473975 | NPI | - | NPPES |
| 207050501 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2086S0129X | Surgery - Vascular Surgery | 2009005897 (Missouri) | Secondary |
| 208600000X | Surgery | 2009005897 (Missouri) | Primary |
| 2086S0127X | Surgery - Trauma Surgery | 2009005897 (Missouri) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Texas County Memorial Hospital | 9436041696 | 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 Hollis Tidmore allows following entities to bill medicare on his behalf.
| Entity Name | Texas County Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1710926928
PECOS PAC ID: 9436041696
Enrollment ID: O20070404000060 |
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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 Hollis Tidmore 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 Hollis Tidmore, MD
1422 S Sam Houston Blvd,
Houston, MO 65483-2130
Ph: (417) 967-1252 | Dr Hollis Tidmore, MD
1422 S Sam Houston Blvd,
Houston, MO 65483-2130
Ph: (417) 967-1252 |
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