TILLIE MIRSKY
NPI 1174226591
Nutritionist in Ashton, MD
About Tillie Mirsky NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TILLIE MIRSKY (NPI 1174226591) is an individual nutritionist in Ashton, Maryland and active in the NPI registry since March 2023.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tillie Mirsky is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Tillie Mirsky reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Hyattsville, MD 20785
- Reassigned Medicare billing, District of Columbia enrollment
- 17 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 Tillie Mirsky's NPI number?
The NPI number for Tillie Mirsky is 1174226591. It was assigned to this individual provider in the NPPES registry on March 24, 2023.
Where is Tillie Mirsky located?
Tillie Mirsky practices at 1400 Tucker Ln, Ashton, MD 20861. The listed phone number is (240) 393-2008.
What is Tillie Mirsky's specialty?
The primary specialty registered for this NPI is Nutritionist with taxonomy code 133N00000X.
Is Tillie Mirsky enrolled in Medicare?
Yes. Tillie Mirsky is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Tillie Mirsky's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tillie Mirsky reassigns Medicare benefits to Wellness Source LLC (Hyattsville, MD). 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 Tillie Mirsky'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 Tillie Mirsky was last updated on November 28, 2023. 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.
# Tillie Mirsky · NPI 1174226591
Nutritionist provider in Ashton, Maryland. Individual provider, active in the CMS NPPES registry since March 24, 2023.
## Identity
- **NPI:** 1174226591 (Entity type: Individual)
- **Enumerated:** March 24, 2023
- **Primary specialty:** Nutritionist · taxonomy 133N00000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1400 TUCKER LN, Ashton, MD 20861-9769
- **Phone:** (240) 393-2008
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Wellness Source LLC (NPI 1780031724, Hyattsville, MD), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 28, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1174226591) · Data from the CMS NPPES public registry.