Jaselyn Harrison Tidmore, OTR/L is a medicare enrolled "Occupational Therapist" provider in Columbiana, Alabama. Her current practice location is
209 W College St, Columbiana, Alabama. You can reach out to her office (for appointments etc.) via phone at
(205) 210-4980.
Jaselyn Harrison Tidmore is licensed to practice in Alabama (license number 5218) 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 1194451468.
Healthcare Provider's Profile
| Full Name | Jaselyn Harrison Tidmore |
|---|
| Gender | Female |
|---|
| Speciality | Occupational Therapist |
|---|
| Location | 209 W College St, Columbiana, Alabama |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1194451468
- Provider Enumeration Date: 07/28/2022
- Last Update Date: 07/28/2022
Medicare PECOS Information:
- PECOS PAC ID: 9830575695
- Enrollment ID: I20220930001959
Medical Identifiers
Medical identifiers for Jaselyn Harrison Tidmore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1194451468 | NPI | - | NPPES |
| 5218 | Other | AL | OCCUPATIONAL THERAPY LICENSE NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225X00000X | Occupational Therapist | 5218 (Alabama) | 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. Jaselyn Harrison Tidmore allows following entities to bill medicare on her behalf.
| Provider Name | Pt Solutions Of Montgomery Llc |
|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
|---|
| Provider Identifiers | NPI Number: 1073558086
PECOS PAC ID: 6305891037
Enrollment ID: O20050316000120 |
|---|
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. Jaselyn Harrison 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 |
|---|
Jaselyn Harrison Tidmore, OTR/L
176 Highway 61,
Columbiana, AL 35051-5258
Ph: (205) 566-2798 | Jaselyn Harrison Tidmore, OTR/L
209 W College St,
Columbiana, AL 35051-9724
Ph: (205) 210-4980 |
Reviews and Comments