SANDRA L TIDWELL (ARNP) – Adult Health Nurse Practitioner, NPI 1366404337
Adult Health Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
6,261 NURSE PRACTITIONER in WA
Provider Addresses for SANDRA L TIDWELL (ARNP)
PO BOX 31001-4114
PASADENA, CA 911100001
Phone: (866) 747-2455
Type: Mailing
62 W 7TH AVE STE 420
SPOKANE, WA 992042321
Phone: (509) 626-9440
Type: Location
421, Liberty Lane, Evesham Township, Burlington County, New Jersey, 08053-5344, United States
LIBERTY LAKE, WA 990190421
Phone: (866) 747-2455
Type: Mailing
West 7th Avenue, Spokane, Spokane County, Washington, 99201, United States
SUITE 420
SPOKANE, WA 992042349
Phone: (509) 626-9440
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $53.
Total Amount is formed as General ($53) + Research ($0) + Ownership ($0) = $53.
Last reported payment date: 2024-03-13 • Largest payer in this snapshot: Medtronic, Inc. ($53).
Total Amount
$53
General + Research + Ownership
Payments
2
Total payment records
General Amount
$53
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $53 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-03-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100325000497 | I | Nurse Practitioner | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 97 | 97 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 37 | 36 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 25 | 22 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 17 | 16 | $0 |
Insurance plans in this area (ZIP 91110)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WA | |
| Internal Medicine | WA | |
| - | WA | |
| Physician Assistant | WA | |
| - | WA | |
| - | WA | |
| Physician Assistant | WA | |
| Internal Medicine | WA | |
| - | WA | |
| - | WA |
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