DR. ALICIA ELLEN TISDALE PHD
NPI 1083622914
Psychologist in West Bloomfield, MI
About Dr. Alicia Ellen Tisdale Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ALICIA ELLEN TISDALE PHD (NPI 1083622914) is an individual psychologist in West Bloomfield, Michigan, licensed in Michigan (6301003007) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1988).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Alicia Ellen Tisdale Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Alicia Tisdale reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Southfield, MI 48075
- Reassigned Medicare billing, Michigan enrollment
- 10 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 Alicia Tisdale's NPI number?
The NPI number for Alicia Tisdale is 1083622914. It was assigned to this individual provider in the NPPES registry on August 4, 2006.
Where is Alicia Tisdale located?
Alicia Tisdale practices at 5101 Willow Pond Drive, West Bloomfield, MI 48323. The listed phone number is (248) 974-1783.
What is Alicia Tisdale's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Alicia Tisdale enrolled in Medicare?
Yes. Alicia Tisdale is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Alicia Tisdale's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Alicia Tisdale reassigns Medicare benefits to Thomas Park M.D. PC (Southfield, MI). The 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 Alicia Tisdale's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Alicia Tisdale was last updated on October 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.