Individual provider Active NPI

Amy E Tissiere

  • Social Worker
  • Columbia, MD
National Provider Identifier
1851943179
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
10710 Charter Dr Ste G020
Columbia, MD 21044-3257
Phone
(410) 964-2212
NPI assigned
Jul 16, 2019
Last updated
Jul 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU Primary

Addresses

Primary practice location

10710 Charter Dr Ste G020
Columbia, MD 21044-3257

Mailing address

11720 Beltsville Dr Ste 300
Beltsville, MD 20705-3119
Phone (240) 223-1799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20190918002793 MD Practitioner - Clinical Social Worker 4082944962 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Maryland Oncology Hematology PAGroup PAC ID 2062302102, 96 clinicians

Practice addresses (Care Compare)

10710 Charter Dr
Suite G020
Columbia, MD 21044-3257
Phone (410) 964-2218

Merit-based Incentive Payment System (MIPS)

Final score
85.83 of 100Reported as group
Quality
71.66
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Oncology Hematology P.a. CurrentSince Jul 30, 2019 Accepting new patients
Maryland Oncology Hematology P.a. CurrentSince Jul 30, 2019 Accepting new patients

Locations

11720 Beltsville Dr
Ste 300
Beltsville, MD 20705

10710 Charter Dr
Ste G020
Columbia, MD 21044
Phone (410) 964-2212

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1851943179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11720 BELTSVILLE DR STE 300",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207053119",
            "telephone_number": "240-223-1799",
            "fax_number": "832-348-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 CHARTER DR STE G020",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443257",
            "telephone_number": "410-964-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISSIERE",
        "first_name": "AMY",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.