Nicholas E Tisdale, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME169907 Issued in FL

Practice address

1715 37TH PL FL 2
Vero Beach, FL 32960-4508

Phone

(772) 794-2222

Fax

(772) 794-0045

NPI assigned

May 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, FL2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Indian River Primary CareGroup PAC ID 0446152789, 10 clinicians

Back in Action Medical Center LLCGroup PAC ID 7810272473, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Activa Home Health Home health agency, Stuart, FL, CCN 108113
• Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105
• Cleveland Clinic Martin North Hospital Hospital, Stuart, FL, CCN 100044
• Jupiter Medical Center Hospital, Jupiter, FL, CCN 100253

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicholas.tisdale@42155926749188.direct.elationemr.com
• FHIR API: https://fhir4.healow.com/fhir/r4/HECFAD
• FHIR API: https://fhir4.healow.com/fhir/r4/GCBABD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Back in Action Medical Center LLC

  • General Practice Physician
  • Palm City, FL
  • NPI 1093183733

  FL

  Medicare reassignment Care Compare group NPD
• Indian River Primary Care

  • Specialist
  • Vero Beach, FL
  • NPI 1023192507

  FL

  Medicare reassignment Care Compare group NPD
• Patient Diagnostics PLLC

  • Internal Medicine Physician
  • West Bloomfield, MI
  • NPI 1063107738

  Internal Medicine, MI

  Medicare reassignment NPD Authorized official
• Aii Medicine PLLC

  • Internal Medicine Physician
  • Roseville, MI
  • NPI 1043048077

  Internal Medicine, MI

  Medicare reassignment NPD
• M&Y Care, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • West Bloomfield, MI
  • NPI 1710527569

  MI

  Medicare reassignment NPD
• Back in Action Medical Center LLC

  • Rehabilitation Clinic/Center
  • Palm City, FL
  • NPI 1225592603
  NPD
• M&Y Care, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Lyndhurst, OH
  • NPI 1184200982
  NPD

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

• Activa Health Services

  • Home Health Agency
  • Vero Beach, FL
  • NPI 1649548777
  Care Compare affiliation
• Activa Health Services, Inc.

  • Home Health Agency
  • Stuart, FL
  • NPI 1770559718
  Care Compare affiliation
• Indian River Memorial Hospital Inc

  • General Acute Care Hospital
  • Vero Beach, FL
  • NPI 1376512988

  Hospital

  Care Compare affiliation
• Jupiter Medical Center, Inc.

  • General Acute Care Hospital
  • Jupiter, FL
  • NPI 1295721090

  Hospital

  Care Compare affiliation
• Martin Memorial Medical Center Inc

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1588464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1962023754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 37TH PL FL 2",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604508",
            "telephone_number": "772-794-2222",
            "fax_number": "772-794-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 37TH PL FL 2",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604508",
            "telephone_number": "772-794-2222",
            "fax_number": "772-794-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "NICHOLAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-03",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "22993",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301507158",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME169907",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.154509",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Tibensky, PT
• Tillyton LLC Ocean Blue Medical
• Timothy L Cocks MD PA
• Alana Tingen, MS, OTR/L
• Julie Barker Tinsley, LCSW
• Titheotokos, LLC
• Titheotokos, LLC
• Juan Titherington
• Subhash R Tiwari, MD
• TJM Home Health Care

• All providers in Vero Beach, FL
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.