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MARY TISDALE CNM
NPI 1992034532
Advanced Practice Midwife in Peoria, IL

Active since December 10, 2009PECOS Enrolled
1001 MAIN ST STE 300, PEORIA, IL 61606(309) 495-0200(309) 676-6545 Get Directions Write a Review

NPPES record last updated: April 5, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 5, 2021, Apr 1, 2021, Jan 15, 2019 and 1 more (4 updates tracked since 2017).

About Mary Tisdale Cnm NPPES

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

MARY TISDALE CNM (NPI 1992034532) is an individual advanced practice midwife in Peoria, Illinois, licensed in Illinois (209007925) and active in the NPI registry since December 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992034532
Entity TypeIndividualFemale
Primary Taxonomy367A00000X
Provider Legal NameMARY TISDALECredential: CNM
Location Address1001 MAIN ST STE 300Peoria, IL 61606-2036
Mailing Address1025 S 6th StSpringfield, IL 62703-2403 · (217) 528-7541 · Fax (772) 879-0436
Phone(309) 495-0200
Fax(309) 676-6545
Sole ProprietorNo
Enumeration DateDecember 10, 2009
Last NPPES UpdateApril 5, 20214 updates tracked since enumeration
NPPES CertifiedApril 5, 2021
✔ NPI 1992034532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367A00000X
Licenses✔ Licensed in IL · 209007925✔ Licensed in FL · APRN11000699
Definition
Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.
Also ListedNurse PractitionerTaxonomy 363L00000X · License 209008217 (IL)
1001 MAIN ST STE 300, Peoria, IL 61606
Open in Google Maps ↗

Other Identifiers 1

Medicaid9337001IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Tisdale Cnm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 61606 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
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 12

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

MICHELLE HEAL
Nurse Practitioner
1001 MAIN ST STE 300
PEORIA, IL 61606
Peoria County (309) 495-0250
SPRINGFIELD CLINIC LLP
Clinic/Center (Multi-Specialty)
1001 MAIN ST STE 300
PEORIA, IL 61606
Peoria County (309) 495-0200
MRS. KAREN A COLLINS APN
Nurse Practitioner (Family)
1001 MAIN ST STE 300
PEORIA, IL 61606
Peoria County (309) 495-0200
GRETCHEN M EVANS D.P.M.
Podiatrist (Foot Surgery)
1001 MAIN ST STE 300
PEORIA, IL 61606
Peoria County (309) 465-0200
DR. JACOB ROYLE HOPPING M.D.
Surgery
1001 MAIN ST STE 300
PEORIA, IL 61606
Peoria County (309) 495-0200
DR. TYLER ANDREW EVANS M.D.
Plastic Surgery
1001 MAIN ST STE 300
PEORIA, IL 61606
Peoria County (217) 528-7541
EDITH JOY KEMP MS RD LD
Dietitian, Registered
1001 MAIN ST STE 300
PEORIA, IL 61606
Peoria County (309) 495-0200
DR. ROBIN A ALLEY MD
Surgery
1001 MAIN ST STE 300
PEORIA, IL 61606
Peoria County (309) 495-0200

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 Tisdale's NPI number?

The NPI number for Mary Tisdale is 1992034532. It was assigned to this individual provider in the NPPES registry on December 10, 2009.

Where is Mary Tisdale located?

Mary Tisdale practices at 1001 Main St Ste 300, Peoria, IL 61606. The listed phone number is (309) 495-0200.

What is Mary Tisdale's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Is Mary Tisdale enrolled in Medicare?

Yes. Mary Tisdale is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mary Tisdale was last updated on April 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.