MRS. LISA ANN TIEBAUER PMHNP-BC
NPI 1700069044
Nurse Practitioner - Psychiatric/Mental Health in Jacksonville, NC
About Mrs. Lisa Ann Tiebauer Pmhnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. LISA ANN TIEBAUER PMHNP-BC (NPI 1700069044) is an individual psychiatric/mental health provider in Jacksonville, North Carolina, licensed in North Carolina (5005198) and active in the NPI registry since December 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2005).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
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
Mrs. Lisa Ann Tiebauer Pmhnp-bc 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 Reassignment
Medicare enrollment records show Lisa Tiebauer reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Jacksonville, NC 28546
- Reassigned Medicare billing, North Carolina enrollment
- 39 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 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 28546 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
JACKSONVILLE, NC 28546
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 Lisa Tiebauer's NPI number?
The NPI number for Lisa Tiebauer is 1700069044. It was assigned to this individual provider in the NPPES registry on December 10, 2007.
Where is Lisa Tiebauer located?
Lisa Tiebauer practices at 200 Tarpon Trl, Jacksonville, NC 28546. The listed phone number is (910) 938-1114.
What is Lisa Tiebauer's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Lisa Tiebauer enrolled in Medicare?
Yes. Lisa Tiebauer 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 organization bills Medicare for Lisa Tiebauer's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Tiebauer reassigns Medicare benefits to Coastal Carolina Neuropsychiatric Center, PA (Jacksonville, NC). 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 Lisa Tiebauer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Lisa Tiebauer accept?
Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, Cigna Healthcare and Oscar Health Plan of North Carolina, Inc and 1 other insurer list Lisa Tiebauer 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 Lisa Tiebauer was last updated on March 7, 2023. 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.
# Mrs. Lisa Ann Tiebauer, PMHNP-BC · NPI 1700069044
Psychiatric/Mental Health physician in Jacksonville, North Carolina. Individual provider, active in the CMS NPPES registry since December 10, 2007.
## Identity
- **NPI:** 1700069044 (Entity type: Individual)
- **Enumerated:** December 10, 2007
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 5005198 (North Carolina)
- **Sole proprietor:** No
## Practice location
- **Address:** 200 TARPON TRL, Jacksonville, NC 28546-5287
- **Phone:** (910) 938-1114 · **Fax:** (910) 938-1118
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Coastal Carolina Neuropsychiatric Center, PA (NPI 1184737462, Jacksonville, NC), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2005
## Record status
- **NPPES last updated:** March 7, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1700069044) · Data from the CMS NPPES public registry.