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MRS. TIA MICHELLE GULLICKSON FNP-C
NPI 1992187868
Nurse Practitioner - Family in Red Lake Falls, MN

Active since June 26, 2015PECOS EnrolledAccepts Medicare Assignment
92.65/100
CMS Quality Rating
105 INTERNATIONAL DR, STE. 126, RED LAKE FALLS, MN 56750(218) 253-4606(218) 253-4681 Get Directions Write a Review

NPPES record last updated: June 26, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Tia Michelle Gullickson Fnp-c NPPES

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

MRS. TIA MICHELLE GULLICKSON FNP-C (NPI 1992187868) is an individual family provider in Red Lake Falls, Minnesota, licensed in Minnesota (CNP 3937) and active in the NPI registry since June 2015. She is enrolled in Medicare PECOS, is affiliated with Riverview Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1992187868
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMRS. TIA MICHELLE GULLICKSONCredential: FNP-C
Location Address105 INTERNATIONAL DR, STE. 126Red Lake Falls, MN 56750-4665
Mailing Address105 International Dr, Ste. 126Red Lake Falls, MN 56750-4665 · (218) 253-4606 · Fax (218) 253-4681
Phone(218) 253-4606
Fax(218) 253-4681
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJune 26, 2015
✔ NPI 1992187868 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MN · CNP 3937
105 INTERNATIONAL DR, Red Lake Falls, MN 56750
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of North Dakota, Medica, Sanford Health Plan.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

Mrs. Tia Michelle Gullickson Fnp-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 ID749593804
PECOS Enrollment IDI20150717001787
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.

Hospital Affiliations CMS Care Compare

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

Riverview Hospital

Critical Access Hospitals · Crookston, MN
OwnershipVoluntary non-profit - Private
CMS Certification Number241320
Location323 South MinnesotaCrookston, MN 56716 · Polk County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 56750 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
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.

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.

92.65/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality87.73
Promoting Interoperability98
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms J7606
DME-Drugs Administered Through DME · category DG006N
2 suppliers12 claims720 services$6.60 avg. paid by Medicare
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg J7626
DME-Drugs Administered Through DME · category DG000N
2 suppliers12 claims720 services$0.81 avg. paid by Medicare
Pharmacy dispensing fee for inhalation drug(s); per 30 days Q0513
DME-Other DME · category DE000N
2 suppliers12 claims12 services$26.09 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

RICHARD WALTER SEEGER RPH
Pharmacist
105 INTERNATIONAL DR
RED LAKE FALLS, MN 56750
Red Lake County (218) 253-3480
RIVERVIEW HEALTHCARE ASSOCIATION
Clinic/Center (Rural Health)
105 INTERNATIONAL DR, SUITE 25
RED LAKE FALLS, MN 56750
Red Lake County (218) 253-4606
1 BODY HEALTH AND FITNESS PA
Chiropractor
105 INTERNATIONAL DR, SUITE 121
RED LAKE FALLS, MN 56750
Red Lake County (218) 253-2111

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 Tia Gullickson's NPI number?

The NPI number for Tia Gullickson is 1992187868. It was assigned to this individual provider in the NPPES registry on June 26, 2015.

Where is Tia Gullickson located?

Tia Gullickson practices at 105 International Dr Ste. 126, Red Lake Falls, MN 56750. The listed phone number is (218) 253-4606.

What is Tia Gullickson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Tia Gullickson enrolled in Medicare?

Yes. Tia Gullickson 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 Tia Gullickson accept?

Health plans from Blue Cross Blue Shield of North Dakota, Medica and Sanford Health Plan list Tia Gullickson 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 Tia Gullickson affiliated with any hospitals?

According to CMS data, Tia Gullickson is affiliated with Riverview Hospital.

When was this NPI record last updated?

The NPPES record for Tia Gullickson was last updated on June 26, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.