Mary Tisdale, CNM in Peoria, IL - Medicare Certified Nurse Midwife (cnm)

Mary Tisdale, CNM is a medicare enrolled "Advanced Practice Midwife" in Peoria, Illinois. She graduated from nursing school in 2009 and has 15 years of diverse experience with area of expertise as Certified Nurse Midwife (cnm). She is a member of the group practice Springfield Clinic Llp and her current practice location is 1001 Main St Ste 300, Peoria, Illinois. You can reach out to her office (for appointments etc.) via phone at (309) 495-0200.

Mary Tisdale is licensed to practice in Illinois (license number 209007925) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1992034532.

Contact Information

	Mary Tisdale, CNM
	1001 Main St Ste 300, Peoria, IL 61606-2036
	(309) 495-0200
	(309) 676-6545

Map and Direction

Provider's Profile

Full Name	Mary Tisdale
Gender	Female
Speciality	Certified Nurse Midwife (cnm)
Experience	15 Years
Location	1001 Main St Ste 300, Peoria, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mary Tisdale graduated from nursing school in 2009

NPI Data:

NPI Number: 1992034532
Provider Enumeration Date: 12/10/2009
Last Update Date: 04/05/2021

Medicare PECOS Information:

PECOS PAC ID: 7810164738
Enrollment ID: I20120118000197

Medical Identifiers

Medical identifiers for Mary Tisdale such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992034532	NPI	-	NPPES
9337001	Medicaid	IL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	209008217 (Illinois)	Secondary
367A00000X	Advanced Practice Midwife	APRN11000699 (Florida)	Secondary
367A00000X	Advanced Practice Midwife	209007925 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Memorial Medical Center	Springfield, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Springfield Clinic Llp	0547166076	673

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. Mary Tisdale allows following entities to bill medicare on her behalf.

Entity Name	Springfield Clinic Llp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780638478 PECOS PAC ID: 0547166076 Enrollment ID: O20040331000826

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. Mary 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
Mary Tisdale, CNM 1025 S 6th St, Springfield, IL 62703-2403 Ph: (217) 528-7541	Mary Tisdale, CNM 1001 Main St Ste 300, Peoria, IL 61606-2036 Ph: (309) 495-0200

Reviews and Comments

Advanced Practice Midwife Nurses in Peoria, IL

Mrs. Dana Humes Goff, A.P.N., C.N.M. Advanced Practice Midwife Medicare: Accepting Medicare Assignments Practice Location: 900 Main St Ste 660, Peoria, IL 61602 Phone: 309-687-4230 Fax: 309-687-7704
Mrs. Angel D Atkins, CNM, WHNP, APN Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 2805 N Knoxville Ave, Peoria, IL 61604 Phone: 309-370-1025 Fax: 309-266-5340
Mrs. Sara Elizabeth Sawyer, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 2709 N Knoxville Ave, Peoria, IL 61604 Phone: 309-681-0350
Nicole Elizabeth Hunt, CNM Advanced Practice Midwife Medicare: Not Enrolled in Medicare Practice Location: 2419 W Cornerstone Ct, Peoria, IL 61614 Phone: 217-528-7541
Jodi E Morse, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 2419 W Cornerstone Ct, Peoria, IL 61614 Phone: 217-528-7541
Kristin M King, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 2419 W Cornerstone Ct, Peoria, IL 61614 Phone: 217-528-7541
Jennifer Lynn Soady, DNP, APRN, CNM Advanced Practice Midwife Medicare: Medicare Enrolled Practice Location: 2419 W Cornerstone Ct, Peoria, IL 61614 Phone: 217-528-7541

Mary Tisdale, CNM - Medicare Certified Nurse Midwife (cnm) in Peoria, IL