CHARLES GIRARD TISDALE PA-C
NPI 1821096686
Physician Assistant - Surgical in Shreveport, LA

Q: What is Charles Tisdale's NPI number?

The NPI number for Charles Tisdale is 1821096686. It was assigned to this individual provider in the NPPES registry on July 14, 2005.

Q: What is Charles Tisdale's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Charles Tisdale was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 July 14, 2005PECOS EnrolledAccepts Medicare Assignment

1500 LINE AVE STE 100, SHREVEPORT, LA 71101(318) 635-3052 Get Directions Write a Review

NPPES record last updated: November 24, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 24, 2025, Aug 23, 2024, Dec 11, 2020 and 1 more (4 updates tracked since 2016).

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About Charles Girard Tisdale Pa-c NPPES

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

CHARLES GIRARD TISDALE PA-C (NPI 1821096686) is an individual surgical provider in Shreveport, Louisiana, licensed in Louisiana (PA.A10284) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS, is affiliated with Rapides Regional Medical Center, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1821096686

Entity TypeIndividualMale

Primary Taxonomy363AS0400X

Provider Legal NameCHARLES GIRARD TISDALECredential: PA-C

Location Address1500 LINE AVE STE 100Shreveport, LA 71101-4644

Mailing Address1500 Line Ave Ste 100Shreveport, LA 71101-4644 · (318) 635-3052

Phone(318) 635-3052

Sole ProprietorNo

Medical School CMSOtherGraduated 1997

Enumeration DateJuly 14, 2005

Last NPPES UpdateNovember 24, 20254 updates tracked since enumeration

NPPES CertifiedNovember 24, 2025

✔ NPI 1821096686 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

Licenses✔ Licensed in LA · PA.A10284✔ Licensed in LA · A10284

1500 LINE AVE STE 100, Shreveport, LA 71101

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Other Identifiers 1

Medicaid1626708LA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, HMO Louisiana.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

Charles Girard Tisdale Pa-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.

PECOS PAC ID9638266562

PECOS Enrollment IDI20090804000005

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 2

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.

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

59 services57 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

58 services56 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Rapides Regional Medical Center

Acute Care Hospitals · Alexandria, LA

2/5 CMS rating

OwnershipProprietary

CMS Certification Number190026

Location211 4th StreetAlexandria, LA 71301 · Rapides County

Emergency services Birthing friendly

Specialists Hospital Shreveport

Acute Care Hospitals · Shreveport, LA

OwnershipProprietary

CMS Certification Number190278

Location1500 Line AvenueShreveport, LA 71101 · Caddo County

Other Providers at the Same Location NPPES 3

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

ANNA HUGHES

Physician Assistant

1500 LINE AVE STE 100
SHREVEPORT, LA 71101

Caddo Parish (318) 564-1966

ANDREW GARRETT PATTON MD

Orthopaedic Surgery

1500 LINE AVE STE 100
SHREVEPORT, LA 71101

Caddo Parish (318) 635-3052

CHARLES MARION LOBRANO III MD

Orthopaedic Surgery

1500 LINE AVE STE 100
SHREVEPORT, LA 71101

Caddo Parish (318) 635-3052

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 Charles Tisdale's NPI number?

The NPI number for Charles Tisdale is 1821096686. It was assigned to this individual provider in the NPPES registry on July 14, 2005.

Where is Charles Tisdale located?

Charles Tisdale practices at 1500 Line Ave Ste 100, Shreveport, LA 71101. The listed phone number is (318) 635-3052.

What is Charles Tisdale's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Charles Tisdale enrolled in Medicare?

Yes. Charles 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.

What insurance does Charles Tisdale accept?

Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana list Charles Tisdale 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.

Is Charles Tisdale affiliated with any hospitals?

According to CMS data, Charles Tisdale is affiliated with Rapides Regional Medical Center and Specialists Hospital Shreveport.

When was this NPI record last updated?

The NPPES record for Charles Tisdale was last updated on November 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.