TISHA JOERLA MIRASOL TAN (M.D.) – Nephrology Physician, NPI 1881959872
Nephrology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
629 NEPHROLOGY in IL
Provider Addresses for TISHA JOERLA MIRASOL TAN (M.D.)
PO BOX 3877
JOLIET, IL 604343877
Phone: (815) 741-6830
Fax: (815) 741-6832
Type: Mailing
1670 Capital St Unit 900
Elgin, IL 601247837
Phone: (847) 285-1908
Type: Location
442 N IL ROUTE 31
CRYSTAL LAKE, IL 600123709
Phone: (224) 238-3211
Fax: (224) 535-8215
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 74 Open Payments records for all available years, with a total value of $1,731.
Total Amount is formed as General ($1,731) + Research ($0) + Ownership ($0) = $1,731.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($280).
Total Amount
$1,731
General + Research + Ownership
Payments
74
Total payment records
General Amount
$1,731
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
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: 2017-03-22
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 |
|---|---|---|---|---|
| I20170322000482 | I | Nephrology | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 1,910 | 508 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,011 | 338 | $0 |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 942 | 143 | $0 |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 510 | 135 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 422 | 357 | $0 |
Insurance plans in this area (ZIP 60434)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nephrology, Internal Medicine | IL | |
| Nephrology, Internal Medicine | IL | |
| Nephrology, Internal Medicine | IL | |
| Nephrology, Internal Medicine | IL |
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