MS. MARY J TICHACEK RN, PMHNP-BC, PMHCNS
NPI 1841836244
Nurse Practitioner - Psychiatric/Mental Health in San Diego, CA

Active since November 20, 2019PECOS EnrolledAccepts Medicare Assignment
11515 EL CAMINO REAL STE 100, SAN DIEGO, CA 92130(858) 279-1223 Get Directions Write a Review

NPPES record last updated: October 29, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 4, 2025, Jun 5, 2023, Jun 1, 2023 and 1 more (4 updates tracked since 2019).

About Ms. Mary J Tichacek Rn, Pmhnp-bc, Pmhcns NPPES

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

MS. MARY J TICHACEK RN, PMHNP-BC, PMHCNS (NPI 1841836244) is an individual psychiatric/mental health provider in San Diego, California, licensed in California (95024198) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Imperial, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1841836244
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMS. MARY J TICHACEKCredential: RN, PMHNP-BC, PMHCNS
Location Address11515 EL CAMINO REAL STE 100San Diego, CA 92130-3034
Mailing Address11515 El Camino Real Ste 100San Diego, CA 92130-3034 · (858) 279-1223
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateNovember 20, 2019
Last NPPES UpdateOctober 29, 20254 updates tracked since enumeration
NPPES CertifiedOctober 29, 2025
✔ NPI 1841836244 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95024198
Also ListedRegistered NurseTaxonomy 163W00000X · License 202048 (CA)
Also ListedClinical Nurse SpecialistTaxonomy 364S00000X · License 207 (CA)
11515 EL CAMINO REAL STE 100, San Diego, CA 92130

Other Names 1

Other Name (5)Ms. Mary Jo Tichacek

Secondary Practice Location 1

Location 12417 Marshall Ave Ste 1Imperial, CA 92251-9401 · Phone (858) 245-1195

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

Ms. Mary J Tichacek Rn, Pmhnp-bc, Pmhcns 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 ID648791442
PECOS Enrollment IDI20250310002287
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 Reassignments

2

Medicare enrollment records show Mary Tichacek reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mental Health
5060 SHOREHAM PL STE 330
San Diego, CA 92122
  • Reassigned Medicare billing, California enrollment
  • 245 clinicians in this Medicare group
Clinical
7373 N SCOTTSDALE RD STE A199
Scottsdale, AZ 85253
  • Reassigned Medicare billing, California enrollment
  • 766 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92130 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
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
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 15

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

Social Worker (Clinical)
11515 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
Clinical Medical Laboratory
11515 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
Psychologist (Clinical)
11515 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
Psychiatry & Neurology (Psychiatry)
11515 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
Psychologist (Clinical)
11515 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
Psychiatry & Neurology (Psychiatry)
11515 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
Social Worker (Clinical)
11515 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130
Social Worker (Clinical)
11515 EL CAMINO REAL STE 100
SAN DIEGO, CA 92130

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 Mary Tichacek's NPI number?

The NPI number for Mary Tichacek is 1841836244. It was assigned to this individual provider in the NPPES registry on November 20, 2019. The provider is also known as Ms. Mary Jo Tichacek.

Where is Mary Tichacek located?

Mary Tichacek practices at 11515 El Camino Real Ste 100, San Diego, CA 92130. The listed phone number is (858) 279-1223.

What is Mary Tichacek's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Mary Tichacek enrolled in Medicare?

Yes. Mary Tichacek 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 Mary Tichacek's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Tichacek reassigns Medicare benefits to 2 organizations: Sokyahealth Medical Group PC (San Diego, CA) and Pacific Coast Psychiatric Associates Inc (Scottsdale, AZ). 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 Mary Tichacek'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 Mary Tichacek was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.