MRS. TIFFANY REED TATE-WOODARD AGNP
NPI 1639719230
Nurse Practitioner - Gerontology in East Saint Louis, IL

Q: What is Tiffany Tate-woodard's NPI number?

The NPI number for Tiffany Tate-woodard is 1639719230. It was assigned to this individual provider in the NPPES registry on January 10, 2020.

Q: What is Tiffany Tate-woodard's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Active since January 10, 2020PECOS EnrolledAccepts Medicare Assignment

2420 STATE ST, EAST SAINT LOUIS, IL 62205(618) 318-8809(618) 615-4205 Get Directions Write a Review

NPPES record last updated: January 8, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 8, 2026, Sep 10, 2025, Mar 25, 2020 and 1 more (4 updates tracked since 2020).

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About Mrs. Tiffany Reed Tate-woodard Agnp NPPES

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

MRS. TIFFANY REED TATE-WOODARD AGNP (NPI 1639719230) is an individual gerontology provider in East Saint Louis, Illinois, licensed in Illinois (209.026757) and active in the NPI registry since January 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1639719230

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameMRS. TIFFANY REED TATE-WOODARDCredential: AGNP

Location Address2420 STATE STEast Saint Louis, IL 62205-2321

Mailing AddressPo Box 746715Atlanta, GA 30374-6715 · (618) 318-8809 · Fax (618) 615-4205

Phone(618) 318-8809

Fax(618) 615-4205

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJanuary 10, 2020

Last NPPES UpdateJanuary 8, 20264 updates tracked since enumeration

NPPES CertifiedJanuary 8, 2026

✔ NPI 1639719230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in IL · 209.026757

2420 STATE ST, East Saint Louis, IL 62205

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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. Tiffany Reed Tate-woodard Agnp 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 ID1153742762

PECOS Enrollment IDI20260115000096

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 62205 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

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 6

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

MRS. DONNA MARIE AVERY NP

Nurse Practitioner (Family)