NPIMap

Individual provider Active NPI

Christopher L Tisdel, M.D.

  • Specialist
  • Ravenna, OH
National Provider Identifier
1548239080
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
081413 Issued in MI
Practice address
6847 N Chestnut St Ste 105
Ravenna, OH 44266-3929
Phone
(330) 297-6030
Fax
(330) 297-4919
NPI assigned
Mar 16, 2006
Last updated
Dec 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 081413 MI Primary

Addresses

Primary practice location

6847 N Chestnut St Ste 105
Ravenna, OH 44266-3929

Mailing address

44555 Woodward Ave Ste 406
Suite 407
Pontiac, MI 48341-5036
Phone (248) 334-0524

Other practice location 1

9318 State Route 14 Ste B1
Streetsboro, OH 44241-5224
Phone (330) 297-6030

Other identifiers 2

IdentifierTypeStateIssuer
0630027OtherMIBLUE CROSS/BLUE SHIELD
4513256MedicaidMI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address christophertisdel@uhps.allscriptsdirect.net
Direct Messaging Address christophertisdel@uhps.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170613002530 OH Practitioner - Orthopedic Surgery 1153210372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Michigan Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

9318 State Route 14
Streetsboro, OH 44241-5224

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement11
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
081413MIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
University Primary Care Practices Inc CurrentSince Jun 1, 2017 Accepting new patients
University Primary Care Practices Inc CurrentSince Jun 1, 2017 Accepting new patients
University Primary Care Practices Past Accepting new patients
Multicare Health System PastSince Dec 22, 2020 Accepting new patients
Neuro Pain Consultants PC Past Accepting new patients
University Hospitals Medical Group Inc PastSince Dec 22, 2020 Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

9318 State Route 14
Fl 3
Streetsboro, OH 44241
Phone (330) 422-0916

Interoperability endpoints

  • Direct secure messaging: ctisdel36860@ehrdirect.uhhospitals.org
  • FHIR API: https://api.platform.athenahealth.com/15471/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1548239080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE STE 406",
            "address_2": "SUITE 407",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415036",
            "telephone_number": "248-334-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6847 N CHESTNUT ST STE 105",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663929",
            "telephone_number": "330-297-6030",
            "fax_number": "330-297-4919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9318 State Route 14 Ste B1",
            "address_purpose": "LOCATION",
            "city": "Streetsboro",
            "state": "OH",
            "postal_code": "442415224",
            "country_code": "US",
            "telephone_number": "330-297-6030",
            "fax_number": "330-297-4919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TISDEL",
        "first_name": "CHRISTOPHER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "081413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0630027",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4513256",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christophertisdel@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "9318 State Route 14 Ste B1",
            "city": "Streetsboro",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442415224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "christophertisdel@uhps.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "6847 N Chestnut St Ste 105",
            "city": "Ravenna",
            "state": "OH",
            "country_code": "US",
            "postal_code": "442663929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

Verify at the official NPI Registry.