Catherine M Tisdall, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

M5220 Issued in TX

Practice address

8431 Fredericksburg Rd
#100
San Antonio, TX 78229-3392

Phone

(210) 615-7171

Fax

(210) 615-6793

NPI assigned

Apr 12, 2006

Last updated

Oct 27, 2009By 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 identifiers 7

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Specialty

Dermatology

Education

University of Washington School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Stephen Miller MD PAGroup PAC ID 6800837659, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.59 of 100Reported as individual

Quality

95.17

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Stephen Miller MD PA

  dba Dermatology San Antonio

  • Dermatology Physician
  • San Antonio, TX
  • NPI 1073584421
  Medicare reassignment Care Compare group NPD
• Karis McCarroll MD PA

  • Specialist
  • San Antonio, TX
  • NPI 1518268747
  NPD (past)

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1871556506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8431 FREDERICKSBURG RD",
            "address_2": "#100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293392",
            "telephone_number": "210-615-7171",
            "fax_number": "210-615-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8431 FREDERICKSBURG RD",
            "address_2": "#100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293392",
            "telephone_number": "210-615-7171",
            "fax_number": "210-615-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALL",
        "first_name": "CATHERINE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "M5220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "M5220",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUP PTAN",
            "identifier": "DG9652",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "742935457",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8X5051",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00605100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN GROUP",
            "identifier": "00203V",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMONY",
            "identifier": "207N00000X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose Tirado
• Regina Tirbeni, M.D.
• Hazel A Tiru, RN BSN
• Glen Edward Tisdale, LPC
• Taylor M Tisdale
• William Alec Tisdall, M.D.
• Jackie Tittle
• Christian Joel Adlao Tiu, RN
• Patricia N Tiu, PMHNP
• Nena Tiukinhoy, FNP

• Dermatology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.