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MRS. REBEKAH JUNE TISDALE FNP-BC
NPI 1295566388
Nurse Practitioner - Family in Waddington, NY

Active since August 09, 2024PECOS EnrolledAccepts Medicare Assignment
4 MONTGOMERY HEIGHTS, WADDINGTON, NY 13694(315) 388-7872(315) 388-4311 Get Directions Write a Review

NPPES record last updated: November 27, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 15, 2024, Aug 9, 2024 (2 updates tracked since 2024).

About Mrs. Rebekah June Tisdale Fnp-bc NPPES

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

MRS. REBEKAH JUNE TISDALE FNP-BC (NPI 1295566388) is an individual family provider in Waddington, New York, licensed in New York (354223) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS, is affiliated with Canton-potsdam Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1295566388
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. REBEKAH JUNE TISDALECredential: FNP-BC
Location Address4 MONTGOMERY HEIGHTSWaddington, NY 13694
Mailing Address4 Montgomery HeightsWaddington, NY 13694 · (315) 388-7872 · Fax (315) 388-4311
Phone(315) 388-7872
Fax(315) 388-4311
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 9, 2024
Last NPPES UpdateNovember 27, 20242 updates tracked since enumeration
NPPES CertifiedAugust 15, 2024
✔ NPI 1295566388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 354223
4 MONTGOMERY HEIGHTS, Waddington, NY 13694
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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 and accepts Medicare assignment

Mrs. Rebekah June Tisdale Fnp-bc 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.

PECOS PAC ID9335679265
PECOS Enrollment IDI20250207001305
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.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Canton-Potsdam Hospital

Acute Care Hospitals · Potsdam, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330197
Location50 Leroy StreetPotsdam, NY 13676 · St. Lawrence County
Emergency services Birthing friendly

Carthage Area Hospital, Inc

Critical Access Hospitals · Carthage, NY
OwnershipVoluntary non-profit - Private
CMS Certification Number331318
Location1001 West StreetCarthage, NY 13619 · Jefferson County
Emergency services

Slhs Massena, Inc

Critical Access Hospitals · Massena, NY
OwnershipVoluntary non-profit - Private
CMS Certification Number331322
Location1 Hospital DriveMassena, NY 13662 · St. Lawrence County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13694 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Rebekah Tisdale's NPI number?

The NPI number for Rebekah Tisdale is 1295566388. It was assigned to this individual provider in the NPPES registry on August 9, 2024.

Where is Rebekah Tisdale located?

Rebekah Tisdale practices at 4 Montgomery Heights, Waddington, NY 13694. The listed phone number is (315) 388-7872.

What is Rebekah Tisdale's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Rebekah Tisdale enrolled in Medicare?

Yes. Rebekah 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.

Is Rebekah Tisdale affiliated with any hospitals?

According to CMS data, Rebekah Tisdale is affiliated with Canton-Potsdam Hospital, Carthage Area Hospital, Inc and Slhs Massena, Inc.

When was this NPI record last updated?

The NPPES record for Rebekah Tisdale was last updated on November 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.