Dr Tywanna L Chisley, MD is a medicare enrolled "Pediatrics" physician in Deer Park, Texas. Her current practice location is
3430 Center St, Deer Park, Texas. You can reach out to her office (for appointments etc.) via phone at
(832) 548-5000.
Dr Tywanna L Chisley is licensed to practice in Texas (license number R1718) 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 1699736397.
Physician's Profile
Full Name | Dr Tywanna L Chisley |
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Gender | Female |
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Speciality | Pediatrics |
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Location | 3430 Center St, Deer Park, Texas |
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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: 1699736397
- Provider Enumeration Date: 03/31/2006
- Last Update Date: 07/19/2019
Medicare PECOS Information:
- PECOS PAC ID: 2769628163
- Enrollment ID: I20190812001538
Medical Identifiers
Medical identifiers for Dr Tywanna L Chisley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699736397 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | R1718 (Texas) | 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. Dr Tywanna L Chisley allows following entities to bill medicare on her behalf.
Entity Name | Pediatric Urgent Care Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1598059776 PECOS PAC ID: 2567891609 Enrollment ID: O20200410001319 |
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Entity Name | Memorial Hermann Urgent Care Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1730821208 PECOS PAC ID: 4880071679 Enrollment ID: O20220517001605 |
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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 Tywanna L Chisley 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 Tywanna L Chisley, MD Po Box 66308, Houston, TX 77266-6308 Ph: (832) 548-5000 | Dr Tywanna L Chisley, MD 3430 Center St, Deer Park, TX 77536-5056 Ph: (832) 548-5000 |
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