Mrs Tilly Burroughs, APNP, PMHNP-BC in Kenosha, WI

Mrs Tilly Burroughs, APNP, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Kenosha, Wisconsin. Her current practice location is 1114 56th St, Kenosha, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (262) 725-4426.

Mrs Tilly Burroughs is licensed to practice in Wisconsin (license number 13216-33) 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 1669109641.

Contact Information

	Mrs Tilly Burroughs, APNP, PMHNP-BC
	1114 56th St, Kenosha, WI 53140-3668
	(262) 725-4426
	(262) 299-7136

Map and Direction

Provider's Profile

Full Name	Mrs Tilly Burroughs
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1114 56th St, Kenosha, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1669109641
Provider Enumeration Date: 08/01/2022
Last Update Date: 02/20/2023

Medicare PECOS Information:

PECOS PAC ID: 9234594995
Enrollment ID: I20230502001678

Medical Identifiers

Medical identifiers for Mrs Tilly Burroughs such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1669109641	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	13216-33 (Wisconsin)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	13216-33 (Wisconsin)	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. Mrs Tilly Burroughs allows following entities to bill medicare on her behalf.

Entity Name	Family Psychiatric Care Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487178984 PECOS PAC ID: 8123385648 Enrollment ID: O20171207002609

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. Mrs Tilly Burroughs 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
Mrs Tilly Burroughs, APNP, PMHNP-BC N2080 Hafs Rd, Genoa City, WI 53128-1105 Ph: () -	Mrs Tilly Burroughs, APNP, PMHNP-BC 1114 56th St, Kenosha, WI 53140-3668 Ph: (262) 725-4426

Reviews and Comments

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Mrs Tilly Burroughs, APNP, PMHNP-BC - Medicare Nurse Practitioner in Kenosha, WI