TIFFANY LYNN BORN PH.D
NPI 1023498649
Psychologist in De Pere, WI

Active since June 09, 2015PECOS Enrolled
555 REDBIRD CIR STE 100, DE PERE, WI 54115(920) 338-6830(920) 445-7289 Get Directions Write a Review

NPPES record last updated: February 10, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tiffany Lynn Born Ph.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIFFANY LYNN BORN PH.D (NPI 1023498649) is an individual psychologist in De Pere, Wisconsin, licensed in Wisconsin (3514-57) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1023498649
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameTIFFANY LYNN BORNCredential: PH.D
Location Address555 REDBIRD CIR STE 100De Pere, WI 54115-7978
Mailing Address301 E Saint Joseph StGreen Bay, WI 54301-2241 · (920) 445-7226 · Fax (920) 445-7229
Fax(920) 445-7289
Sole ProprietorNo
Enumeration DateJune 9, 2015
Last NPPES UpdateFebruary 10, 2021
NPPES CertifiedFebruary 10, 2021
✔ NPI 1023498649 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in WI · 3514-57
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
555 REDBIRD CIR STE 100, De Pere, WI 54115

Secondary Practice Locations 2

Location 1707 N BroadwayBaltimore, MD 21205-1832 · Phone (443) 923-1872
Location 2301 E Saint Joseph StGreen Bay, WI 54301-2241 · Phone (920) 433-6073 · Fax (920) 431-0333

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tiffany Lynn Born Ph.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Tiffany Born reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pediatrics
555 REDBIRD CIR
De Pere, WI 54115
  • Reassigned Medicare billing, Wisconsin enrollment
  • 875 clinicians in this Medicare group
Mental Health (Including Community Mental Health Center)
555 REDBIRD CIR
De Pere, WI 54115
  • Reassigned Medicare billing, Wisconsin enrollment
  • 106 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tiffany Born's NPI number?

The NPI number for Tiffany Born is 1023498649. It was assigned to this individual provider in the NPPES registry on June 9, 2015.

Where is Tiffany Born located?

Tiffany Born practices at 555 Redbird Cir Ste 100, De Pere, WI 54115. The listed phone number is (920) 338-6830.

What is Tiffany Born's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Tiffany Born enrolled in Medicare?

Yes. Tiffany Born is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Tiffany Born's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tiffany Born reassigns Medicare benefits to 2 organizations: Bellin Memorial Hospital Inc (De Pere, WI) and Bellin Psychiatric Center Inc (De Pere, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tiffany Born's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tiffany Born accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and UnitedHealthcare list Tiffany Born as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tiffany Born was last updated on February 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.