Timothy Tisdale, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.1693 Issued in AL

Practice address

188 Hospital Dr Ste 100
Fairhope, AL 36532-2038

Phone

(251) 607-9797

NPI assigned

Jan 13, 2021

Last updated

Sep 11, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Physician Assistant

Education

University of South Alabama College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Services of the Gulf Coast LLCGroup PAC ID 8426301607, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16974/brand/1/csg/1/fhir/r4
• Direct secure messaging: timothy.tisdale.1@24353.direct.athenahealth.com
• Direct secure messaging: timothytisdale@cam.allscriptsdirect.net

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.

• Physician Services of the Gulf Coast LLC

  dba AlphaCare Urgent Care

  • Urgent Care Clinic/Center
  • Biloxi, MS
  • NPI 1366922023

  AL

  Medicare reassignment Care Compare group
• Cardiology Associates of Mobile Inc

  dba Cardiology Associates / Eastern Shore Internal Medicine

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1861666711
  Medicare reassignment NPD
• Donald B Plummer LLC

  • Infectious Disease Physician
  • Foley, AL
  • NPI 1730690413
  NPD (past)

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1770172785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 UNIVERSITY HOSPITAL DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL DR STE 100",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322038",
            "telephone_number": "251-607-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "TIMOTHY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-13",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.1693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Harris Thompson, M.D.
• Rachel G Thompson, PA-C
• Ellen Scott Thomson, RN, BSN, IBCLC
• Remonica Thurmond, PMHNP-BC
• Anna Reid Tindle, CRNP
• Mallory Tobon, PA-C
• Melissa McCraney Tompkins, NP-C
• Hanson C Ton, MD
• Suzanne Tormoen, M.D.
• Sebastian Antonio Torres, DMD

• Physician Assistant in Fairhope, AL
• Providers in Fairhope, AL by specialty
• Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; 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.