TIFFANY SAMMONS PETREY (AGACNP-BC) – Nurse Practitioner, NPI 1992313902
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,658 NURSE PRACTITIONER in GA
Provider Addresses for TIFFANY SAMMONS PETREY (AGACNP-BC)
206 HOSPITAL DR STE A
DUBLIN, GA 310212560
Phone:
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 62 Open Payments records for all available years, with a total value of $5,818.
Total Amount is formed as General ($5,818) + Research ($0) + Ownership ($0) = $5,818.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ZOLL Services LLC (A/K/A ZOLL LifeCor Corp) ($5,005).
Total Amount
$5,818
General + Research + Ownership
Payments
62
Total payment records
General Amount
$5,818
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2026-01-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20200820002715 | I | Nurse Practitioner | GA | TBD |
| I20260108002307 | I | Nurse Practitioner | MD | TBD |
| I20260108002619 | I | Nurse Practitioner | DC | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 445 | 317 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 243 | 206 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 196 | 87 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 85 | 80 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 48 | 48 | $0 |
Insurance plans in this area (ZIP 31021)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | MD | |
| - | MD | |
| - | MD | |
| - | MD | |
| Internal Medicine | MD | |
| Critical Care (Intensivists), Sleep Medicine, Pulmonary Disease | MD | |
| - | MD | |
| Diagnostic Radiology, Interventional Radiology | PA | |
| Geriatric Medicine, Internal Medicine | MD | |
| Orthopedic Surgery | MD |
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