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TRISTAN SHAE FORTNER BS, RBT
NPI 1558977751
Counselor - Mental Health in London, OH

Active since September 22, 2020PECOS Enrolled
1375 US HIGHWAY 42 SE STE C, LONDON, OH 43140(614) 879-8067(614) 503-0899 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 23, 2026, Sep 22, 2020 (2 updates tracked since 2020).

About Tristan Shae Fortner Bs, Rbt NPPES

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

TRISTAN SHAE FORTNER BS, RBT (NPI 1558977751) is an individual mental health provider in London, Ohio, licensed in Ohio (E.2607356) and active in the NPI registry since September 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Hilliard, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1558977751
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameTRISTAN SHAE FORTNERCredential: BS, RBT
Location Address1375 US HIGHWAY 42 SE STE CLondon, OH 43140-9548
Mailing Address1375 Us Highway 42 Se, Ste CLondon, OH 43140-9548 · (614) 879-8067 · Fax (614) 503-0899
Phone(614) 879-8067
Fax(614) 503-0899
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateSeptember 22, 2020
Last NPPES UpdateJuly 23, 20262 updates tracked since enumeration
NPPES CertifiedJuly 23, 2026
✔ NPI 1558977751 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OH · E.2607356
1375 US HIGHWAY 42 SE STE C, London, OH 43140
Open in Google Maps ↗

Secondary Practice Location 1

Location 15548 Hilliard Rome Office ParkHilliard, OH 43026-7286 · Phone (740) 845-8652 · Fax (614) 503-0899

Other Identifiers 1

Medicaid0040142OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Oscar Health Insurance, Oscar Insurance Corporation of Ohio.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tristan Shae Fortner Bs, Rbt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7810455656
PECOS Enrollment IDI20260821000938
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.

Medicare Billing Reassignment

Medicare enrollment records show Tristan Fortner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Counseling And Neurotherapy Associates LLC
Same address
Community/Behavioral Health
1375 US HIGHWAY 42 SE STE C
London, OH 43140
  • Reassigned Medicare billing, Ohio enrollment
  • 8 clinicians in this Medicare group
NPI 1801000120 (740) 845-8652

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

SUSAN CONTE
Counselor (Mental Health)
1375 US HIGHWAY 42 SE STE C
LONDON, OH 43140
Madison County (740) 845-8652
AINSLEY TUCKER CT
Counselor (Mental Health)
1375 US HIGHWAY 42 SE STE C
LONDON, OH 43140
Madison County (740) 845-8652
ALEX WISLER
Counselor (Mental Health)
1375 US HIGHWAY 42 SE STE C
LONDON, OH 43140
Madison County (740) 845-8652
COUNSELING AND NEUROTHERAPY ASSOCIATES LLC
Community/Behavioral Health
1375 US HIGHWAY 42 SE STE C
LONDON, OH 43140
Madison County (614) 879-8067
KAITLYN FORMIGONI LSW
Social Worker
1375 US HIGHWAY 42 SE STE C
LONDON, OH 43140
Madison County (740) 845-8652
JOSHUA HAMRICK
Counselor (Mental Health)
1375 US HIGHWAY 42 SE STE C
LONDON, OH 43140
Madison County (740) 845-8652
KATHLEEN ARTHUR
Counselor (Mental Health)
1375 US HIGHWAY 42 SE STE C
LONDON, OH 43140
Madison County (740) 845-8652
LESLEY ROBIN PUETT LISW-S
Social Worker (Clinical)
1375 US HIGHWAY 42 SE STE C
LONDON, OH 43140
Madison County (740) 845-8652

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 Tristan Fortner's NPI number?

The NPI number for Tristan Fortner is 1558977751. It was assigned to this individual provider in the NPPES registry on September 22, 2020.

Where is Tristan Fortner located?

Tristan Fortner practices at 1375 Us Highway 42 SE Ste C, London, OH 43140. The listed phone number is (614) 879-8067.

What is Tristan Fortner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Tristan Fortner enrolled in Medicare?

Yes. Tristan Fortner is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tristan Fortner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tristan Fortner reassigns Medicare benefits to Counseling And Neurotherapy Associates LLC (London, OH). 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 Tristan Fortner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tristan Fortner accept?

Health plans from Anthem Blue Cross and Blue Shield, Oscar Health Insurance and Oscar Insurance Corporation of Ohio list Tristan Fortner 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 Tristan Fortner was last updated on July 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.