MITZI BRADDOCK TYRE (FNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1396983227
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,652 NURSE PRACTITIONER in GA
Provider Addresses for MITZI BRADDOCK TYRE (FNP)
5 Executive Cir
Savannah, GA 314063345
Phone: (912) 349-9777
Type: Location
2900 MOSSY OAK TRL
WAYCROSS, GA 315034621
Phone: (912) 387-7737
Type: Mailing
1007 MARY ST
WAYCROSS, GA 315033823
Phone: (912) 387-7737
Fax: (912) 449-7080
Type: Location
711, Knight Avenue, Waycross, Ware County, Georgia, 31501, United States
WAYCROSS, GA 315011943
Phone: (912) 548-0710
Fax: (912) 548-0071
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $431.
Total Amount is formed as General ($431) + Research ($0) + Ownership ($0) = $431.
Last reported payment date: 2024-10-29 • Largest payer in this snapshot: Alkermes, Inc. ($184).
Total Amount
$431
General + Research + Ownership
Payments
11
Total payment records
General Amount
$431
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alkermes, Inc. | $184 |
| Neurocrine BioSciences Inc. | $83 |
| Axsome Therapeutics, Inc. | $79 |
| Indivior Inc. | $33 |
| Neurocrine BioSciences, Inc. | $28 |
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: 2024-10-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20110815000504 | I | Nurse Practitioner | GA | TBD |
| I20241010001976 | I | Nurse Practitioner | FL | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 56 | 32 | $0 |
| Q3014 | Telehealth originating site facility fee | 27 | 17 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 19 | 14 | $0 |
Insurance plans in this area (ZIP 31406)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | GA | |
| Nurse Practitioner | GA |
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