Sarita Consuelo Tiza, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25882 Issued in MN

Practice address

400 E 1St St
Morris, MN 56267-1408

Phone

(507) 451-2630

NPI assigned

Jul 26, 2019

Last updated

Oct 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sarita Consuelo Ennis Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

85.11 of 100Reported as group

Quality

82.21

Promoting interoperability

83

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Stevens Community Medical Center Inc

  • Critical Access Hospital
  • Morris, MN
  • NPI 1487678942
  Medicare reassignment NPD
• Stevens Community Medical Center Inc.

  dba Starbuck Clinic

  • Clinic/Center
  • Starbuck, MN
  • NPI 1417105552
  Medicare reassignment NPD
• Stevens Community Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Morris, MN
  • NPI 1366543662
  NPD
• Stevens Community Medical Center Inc

  dba Stevens Community Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Morris, MN
  • NPI 1649705690
  NPD

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1700430832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 8TH AVE NE",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550601504",
            "telephone_number": "507-676-2979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 1ST ST",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "562671408",
            "telephone_number": "507-451-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIZA",
        "first_name": "SARITA",
        "middle_name": "CONSUELO",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-26",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARITA",
            "last_name": "ENNIS",
            "middle_name": "CONSUELO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Valerie J Thompson, NP
• Alyssa Kate Thooft, R.D.
• Tierza Thormodson
• Thrifty Drug Stores Inc (Thrifty White Pharmacy #742)
• Thrive Behavioral Network IV, LLC (New Visions Center)
• Evan B Varga, RPH
• Mike Vig, P.T.
• Tammy Vig, O.T.
• Somkiat Viratyosin, MD
• Christopher Arnold Wanner, M.D,

• Clinical Social Worker in Morris, MN
• Providers in Morris, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.