Chuckia Nicole Brown-Tisdale, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0063718 Issued in MD

Practice address

11110 Medical Campus Rd Ste 143
Hagerstown, MD 21742-6755

Phone

(301) 714-4175

Fax

(301) 714-4183

NPI assigned

Oct 26, 2005

Last updated

Jan 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Internal Medicine

Education

Virginia Commonwealth University, School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, shared by 7 NPIs, 764 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Johns Hopkins Hospital, the Hospital, Baltimore, MD, CCN 210009
• Frederick Health Hospital Hospital, Frederick, MD, CCN 210005

Merit-based Incentive Payment System (MIPS)

Final score

87.23 of 100Reported as group

Quality

80.47

Promoting interoperability

100

Improvement activities

40

Cost

76.96

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbrowntisdale800810@direct.hopkinsmedicine.org

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

• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1578598868

  DC

  Medicare reassignment NPD
• Johns Hopkins Community Physicians, Inc

  dba JHCP - 195 Thomas Johnson Drive

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1770518003
  Medicare reassignment NPD
• Johns Hopkins Community Physicians

  dba JHCP- 6225 Smith Avenue; Mental Health Therapy

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1356161806

  Internal Medicine

  NPD
• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1255359972
  NPD
• Johns Hopkins Community Physicians, Inc

  dba JHCP Johns Hopkins Healthcare

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1720540925
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  Care Compare affiliation
• The Johns Hopkins Hospital

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1578597993
  Care Compare affiliation

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1306836804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 143",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426755",
            "telephone_number": "301-714-4175",
            "fax_number": "301-714-4183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11110 Medical Campus Rd",
            "address_2": "Suite 243",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217426700",
            "country_code": "US",
            "telephone_number": "301-665-4600",
            "fax_number": "301-665-4601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN-TISDALE",
        "first_name": "CHUCKIA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0063718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409370400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke's House, Inc.
• Brooke's House, Inc.
• Brandon Brooks, DO
• Linda Brooks
• Robert Louis Brooks, M.D.
• Anntana Michelle Brown, LGPC
• Barry L Brown, P.T.
• Brook Brown, FNP-C
• Christeena Brown, CRNP
• Jamaal Brown, LGPC

• Internal Medicine Physician in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.