MITZI BRADDOCK TYRE FNP
NPI 1396983227
Nurse Practitioner - Psychiatric/Mental Health in Waycross, GA

Q: What is Mitzi Tyre's NPI number?

The NPI number for Mitzi Tyre is 1396983227. It was assigned to this individual provider in the NPPES registry on January 30, 2009. The provider is also known as Mitz Braddock Tyre Fnp.

Q: What is Mitzi Tyre'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 Mitzi Tyre was last updated on August 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.

Active since January 30, 2009PECOS EnrolledAccepts Medicare Assignment

1007 MARY ST, WAYCROSS, GA 31503(912) 387-7737(912) 449-7080 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mitzi Braddock Tyre Fnp NPPES

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

MITZI BRADDOCK TYRE FNP (NPI 1396983227) is an individual psychiatric/mental health provider in Waycross, Georgia, licensed in Georgia (RN170702) and active in the NPI registry since January 2009. She is enrolled in Medicare PECOS, maintains a secondary practice location in Savannah, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1396983227

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMITZI BRADDOCK TYRECredential: FNP

Location Address1007 MARY STWaycross, GA 31503-3823

Mailing Address2900 Mossy Oak TrlWaycross, GA 31503-4621 · (912) 387-7737

Phone(912) 387-7737

Fax(912) 449-7080

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateJanuary 30, 2009

Last NPPES UpdateAugust 20, 2024

NPPES CertifiedAugust 20, 2024

✔ NPI 1396983227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

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

Taxonomy Code363LP0808X

License✔ Licensed in GA · RN170702

Also ListedRegistered NurseTaxonomy 163W00000X · License RN170702 (GA)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License RN170702 (GA)

1007 MARY ST, Waycross, GA 31503

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Other Names 1

Other Name (5)Mitz Braddock Tyre Fnp

Secondary Practice Location 1

Location 15 Executive CirSavannah, GA 31406-3345 · Phone (912) 349-9777

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

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

Mitzi Braddock Tyre Fnp 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 ID6800065582

PECOS Enrollment IDI20110815000504, I20241010001976

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

63 services35 patients

Telehealth originating site facility fee Q3014

The Telehealth originating site facility fee is a charge for the location where you receive your telehealth service, such as a clinic or hospital. It covers costs like equipment use, technical support, and other resources needed to provide a secure, effective telehealth visit.

23 services11 patients

Psychiatric diagnostic evaluation with medical services 90792

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31503 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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 20

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

MISTY BURCHETTE

Counselor