MR. BRUCE BERNARD TISDALE DSW, LICSW, LCSW-C
NPI 1588816490
Social Worker - Clinical in Suitland, MD
About Mr. Bruce Bernard Tisdale Dsw, Licsw, Lcsw-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. BRUCE BERNARD TISDALE DSW, LICSW, LCSW-C (NPI 1588816490) is an individual clinical provider in Suitland, Maryland, licensed in Maryland (G11619) and active in the NPI registry since October 2008. He is enrolled in Medicare PECOS and is a graduate of Other (2004).
NPPES Registry Identity
Specialties & Licenses 4
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mr. Bruce Bernard Tisdale Dsw, Licsw, Lcsw-c 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.
Medicare Billing Reassignments
3Medicare enrollment records show Bruce Tisdale reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Suitland, MD 20746
- Reassigned Medicare billing, District of Columbia enrollment
Washington, DC 20020
- Reassigned Medicare billing, District of Columbia enrollment
Washington, DC 20012
- Reassigned Medicare billing, District of Columbia enrollment
- 3 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.
Areas of Expertise CMS Part B claims
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 20746 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Bruce Tisdale's NPI number?
The NPI number for Bruce Tisdale is 1588816490. It was assigned to this individual provider in the NPPES registry on October 22, 2008.
Where is Bruce Tisdale located?
Bruce Tisdale practices at 5211 Auth Road St 203, Suitland, MD 20746. The listed phone number is (202) 257-6632.
What is Bruce Tisdale's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Bruce Tisdale enrolled in Medicare?
Yes. Bruce 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.
Which organizations bill Medicare for Bruce Tisdale's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Bruce Tisdale reassigns Medicare benefits to 3 organizations: Hope 4 You, LLC (Suitland, MD), The Family Wellness Center, Inc (Washington, DC) and Kahak, Inc. (Washington, DC). Each 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 Bruce Tisdale'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 Bruce Tisdale was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 27 days 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.
# Mr. Bruce Bernard Tisdale, DSW, LICSW, LCSW-C · NPI 1588816490
Clinical provider in Suitland, Maryland. Individual provider, active in the CMS NPPES registry since October 22, 2008.
## Identity
- **NPI:** 1588816490 (Entity type: Individual)
- **Enumerated:** October 22, 2008
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** G11619 (Maryland)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 5211 AUTH ROAD ST 203, Suitland, MD 20746
- **Phone:** (202) 257-6632
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Hope 4 You, LLC (NPI 1679948053, Suitland, MD); The Family Wellness Center, Inc (NPI 1609141704, Washington, DC); Kahak, Inc. (NPI 1568638187, Washington, DC) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2004
## Record status
- **NPPES last updated:** September 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1588816490) · Data from the CMS NPPES public registry.