Individual provider Active NPI

Tiffany Nicole McDonald, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brandon, FL
National Provider Identifier
1174337356
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11037575 Issued in FL
Practice address
1602 Oakfield Dr Ste 205
Brandon, FL 33511-0827
Phone
(813) 655-6367
NPI assigned
Feb 6, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11037575 FL Primary

Addresses

Primary practice location

1602 Oakfield Dr Ste 205
Brandon, FL 33511-0827

Mailing address

1602 Oakfield Dr Ste 205
Brandon, FL 33511-0827
Phone (813) 655-6367

Other practice location 1

106 W Windhorst Rd
Brandon, FL 33510-2455
Phone (813) 373-9531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250415004067 FL Practitioner - Nurse Practitioner 6406371137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1602 Oakfield Dr
Suite 205
Brandon, FL 33511-0827
Phone (813) 655-6367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11037575FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bonita Springs Retirement Village, Inc. CurrentSince Apr 9, 2025 Accepting new patients
Dna Comprehensive Therapy Services, LLC CurrentSince Apr 9, 2025 Accepting new patients

Locations

1602 Oakfield Dr
Ste 205
Brandon, FL 33511
Phone (813) 655-6367

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: tiffany.mcdonald.1@13142.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1174337356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 OAKFIELD DR STE 205",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335110827",
            "telephone_number": "813-655-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 OAKFIELD DR STE 205",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335110827",
            "telephone_number": "813-655-6367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 W Windhorst Rd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335102455",
            "country_code": "US",
            "telephone_number": "813-373-9531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11037575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.