DR. TINA BETTY EZEOLISAH DNP, PMHNP-BC
NPI 1306299268
Nurse Practitioner - Psychiatric/Mental Health in Duluth, GA

Q: What is Tina Ezeolisah's NPI number?

The NPI number for Tina Ezeolisah is 1306299268. It was assigned to this individual provider in the NPPES registry on July 15, 2016.

Q: What is Tina Ezeolisah's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Tina Ezeolisah was last updated on December 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 15, 2016PECOS Enrolled

3355 MCDANIEL RD, APT 17401, DULUTH, GA 30096(678) 704-3593 Get Directions Write a Review

NPPES record last updated: December 2, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 2, 2022, May 3, 2021, Nov 19, 2020 and 3 more (6 updates tracked since 2016).

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About Dr. Tina Betty Ezeolisah Dnp, Pmhnp-bc NPPES

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

DR. TINA BETTY EZEOLISAH DNP, PMHNP-BC (NPI 1306299268) is an individual psychiatric/mental health provider in Duluth, Georgia, licensed in Georgia (RN217223) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1306299268

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameDR. TINA BETTY EZEOLISAHCredential: DNP, PMHNP-BC

Location Address3355 MCDANIEL RD, APT 17401Duluth, GA 30096-8613

Mailing Address1814 Clairmont RdDecatur, GA 30033-3405 · (404) 636-1457

Phone(678) 704-3593

Sole ProprietorYes

Enumeration DateJuly 15, 2016

Last NPPES UpdateDecember 2, 20226 updates tracked since enumeration

NPPES CertifiedDecember 2, 2022

✔ NPI 1306299268 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in GA · RN217223✔ Licensed in MA · RN2345725✔ Licensed in CO · C-APN.0002066-C-NP✔ Licensed in RI · 05031

Also ListedRegistered NurseTaxonomy 163W00000X · License RN 217223 (GA)

3355 MCDANIEL RD, Duluth, GA 30096

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Secondary Practice Locations 2

Location 1940 Concord Rd SESmyrna, GA 30080-4204 · Phone (404) 636-1457 · Fax (404) 636-7449

Location 21814 Clairmont RdDecatur, GA 30033-3405 · Phone (404) 636-1457 · Fax (404) 636-7449

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tina Betty Ezeolisah Dnp, Pmhnp-bc 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30096 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

Other Providers at the Same Location NPPES

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

ANGELA CHRISTIAN

Counselor (Mental Health)

3355 MCDANIEL RD, APT 10203
DULUTH, GA 30096

Gwinnett County (804) 937-1117

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 Tina Ezeolisah's NPI number?

The NPI number for Tina Ezeolisah is 1306299268. It was assigned to this individual provider in the NPPES registry on July 15, 2016.

Where is Tina Ezeolisah located?

Tina Ezeolisah practices at 3355 Mcdaniel Rd Apt 17401, Duluth, GA 30096. The listed phone number is (678) 704-3593.

What is Tina Ezeolisah's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Tina Ezeolisah enrolled in Medicare?

Yes. Tina Ezeolisah is registered in the Medicare PECOS enrollment system.

What insurance does Tina Ezeolisah accept?

Health plans from Oscar Insurance Company list Tina Ezeolisah 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 Tina Ezeolisah was last updated on December 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.