TIFFANY HENDRICKSON APRN
NPI 1891284469
Nurse Practitioner - Family in Park City, IL
About Tiffany Hendrickson Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIFFANY HENDRICKSON APRN (NPI 1891284469) is an individual family provider in Park City, Illinois, licensed in Illinois (209027553) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tiffany Hendrickson Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Tiffany Hendrickson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Myers, FL 33916
- Reassigned Medicare billing, Florida enrollment
- 1,345 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 60085 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PARK CITY, IL 60085
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 Tiffany Hendrickson's NPI number?
The NPI number for Tiffany Hendrickson is 1891284469. It was assigned to this individual provider in the NPPES registry on May 9, 2018.
Where is Tiffany Hendrickson located?
Tiffany Hendrickson practices at 401 Greenleaf St Ste 1, Park City, IL 60085. The listed phone number is (847) 662-0978.
What is Tiffany Hendrickson's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Tiffany Hendrickson enrolled in Medicare?
Yes. Tiffany Hendrickson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Tiffany Hendrickson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tiffany Hendrickson reassigns Medicare benefits to Lee Memorial Health System (Fort Myers, FL). 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 Tiffany Hendrickson'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 Tiffany Hendrickson was last updated on December 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.
# Tiffany Hendrickson, APRN · NPI 1891284469
Family physician in Park City, Illinois. Individual provider, active in the CMS NPPES registry since May 9, 2018.
## Identity
- **NPI:** 1891284469 (Entity type: Individual)
- **Enumerated:** May 9, 2018
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 209027553 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 401 GREENLEAF ST STE 1, Park City, IL 60085-5744
- **Phone:** (847) 662-0978
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Lee Memorial Health System (NPI 1447099973, Fort Myers, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 20, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1891284469) · Data from the CMS NPPES public registry.