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ELI PEARSON TIDWELL
NPI 1043070543
Student in an Organized Health Care Education/Training Program in Ypsilanti, MI

Active since March 21, 2024PECOS Enrolled
5333 MCAULEY DR, YPSILANTI, MI 48197(734) 712-3980 Get Directions Write a Review

NPPES record last updated: March 21, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eli Pearson Tidwell NPPES

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

ELI PEARSON TIDWELL (NPI 1043070543) is an individual student in an organized health care education/training program in Ypsilanti, Michigan and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1043070543
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameELI PEARSON TIDWELL
Location Address5333 MCAULEY DRYpsilanti, MI 48197-1014
Mailing Address5333 Mcauley Dr Rm 4001Ypsilanti, MI 48197-1099 · (734) 712-3980
Phone(734) 712-3980
Sole ProprietorNo
Enumeration DateMarch 21, 2024
NPPES CertifiedMarch 20, 2024
✔ NPI 1043070543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
5333 MCAULEY DR, Ypsilanti, MI 48197
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eli Pearson Tidwell 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ARDEN BASLER RN
Registered Nurse (Women's Health Care, Ambulatory)
5333 MCAULEY DR, RHB 2110
YPSILANTI, MI 48197
Washtenaw County (734) 712-3126
MORGAN MURDOCK CNP
Internal Medicine (Addiction Medicine)
5333 MCAULEY DR, SUITE 3111
YPSILANTI, MI 48197
Washtenaw County (734) 712-8676
DR. VISHAL BHAGAT M.D.
Radiology (Vascular & Interventional Radiology)
5333 MCAULEY DR, SUITE 6016
YPSILANTI, MI 48197
Washtenaw County (734) 712-8350
ST JOSEPH MERCY HOSPITAL
Internal Medicine
5333 MCAULEY DR, SUITE 4001
YPSILANTI, MI 48197
Washtenaw County (734) 712-3980
DR. GIL S. BORLAZA M.D.
Radiology (Diagnostic Radiology)
5333 MCAULEY DR, SUITE 6016
YPSILANTI, MI 48197
Washtenaw County (734) 712-8350
MS. MICHELLE SCHNAPER OKUN MS, APRN, BC
Nurse Practitioner (Adult Health)
5333 MCAULEY DR, SUITE 4106
YPSILANTI, MI 48197
Washtenaw County (734) 712-5637
THERON LEROY DOBSON M.D.
Psychiatry & Neurology (Neurology)
5333 MCAULEY DR, STE 6109
YPSILANTI, MI 48197
Washtenaw County (734) 712-1400
DR. JENNIFER ELLEN DOBLE M.D.
Physical Medicine & Rehabilitation
5333 MCAULEY DR, SUITE R2009
YPSILANTI, MI 48197
Washtenaw County (734) 712-0050

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 Eli Tidwell's NPI number?

The NPI number for Eli Tidwell is 1043070543. It was assigned to this individual provider in the NPPES registry on March 21, 2024.

Where is Eli Tidwell located?

Eli Tidwell practices at 5333 Mcauley Dr, Ypsilanti, MI 48197. The listed phone number is (734) 712-3980.

What is Eli Tidwell's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Eli Tidwell enrolled in Medicare?

Yes. Eli Tidwell is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Eli Tidwell was last updated on March 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.