SANDRA TATE (APN, PMNCNS-BC) – Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist, NPI 1326093493
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SANDRA TATE (APN, PMNCNS-BC)
1601 MEDLIN RD
CENTRALIA, IL 628019531
Phone: (618) 292-9999
Type: Mailing
PO BOX 155
CHRISTOPHER, IL 628220155
Phone: (618) 724-2401
Fax: (618) 724-4628
Type: Mailing
3412 OFFICE PARK DR
MARION, IL 629596477
Phone: (618) 292-9999
Fax: (618) 551-2757
Type: Location
2920, Veterans Memorial Drive, Mount Vernon, Jefferson County, Illinois, 62864, United States
MOUNT VERNON, IL 628645924
Phone: (618) 244-6544
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 19 Open Payments records for all available years, with a total value of $457.
Total Amount is formed as General ($457) + Research ($0) + Ownership ($0) = $457.
Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Corium, LLC ($162).
Total Amount
$457
General + Research + Ownership
Payments
19
Total payment records
General Amount
$457
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Corium, LLC | $162 |
| ITI, Inc. | $48 |
| Supernus Pharmaceuticals, Inc. | $39 |
| Ironshore Pharmaceuticals Inc. | $37 |
| Neurocrine BioSciences Inc. | $34 |
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: 2015-04-15
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 |
|---|---|---|---|---|
| I20050314000599 | I | Nurse Practitioner | IL | TBD |
| I20150415002081 | I | Certified Clinical Nurse Specialist (Cns) | IL | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62801)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | IL | |
| Internal Medicine | IL | |
| - | MO | |
| Cardiovascular Disease (Cardiology), Internal Medicine | IL | |
| - | IL | |
| Pulmonary Disease, Critical Care (Intensivists) | IL | |
| Nurse Practitioner | IL | |
| Internal Medicine | IL | |
| Nurse Practitioner | IL | |
| General Practice | IL |
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