TRISTAN K LINEBERRY (MD) – Family Medicine Physician, NPI 1336245349

TRISTAN K LINEBERRY (MD) is a healthcare provider. based in Providence, Kentucky. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 21614 (KY). The NPI Number for TRISTAN K LINEBERRY (MD) is 1336245349

Main info

Male
46 Years Of Experience
Accepts Medicare Assignment
Name
TRISTAN K LINEBERRY (MD)
NPI
1336245349
Phone
(270) 667-7017
Address
PO BOX 37
Enumeration Date
16 September 2006
Last Update Date
2 March 2018

Doctor Profile

Medical School Name
UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Secondary Phone
2706677017
Graduation Year
1980 (46 years ago)
PAC ID
5698817666
Group Practice PAC ID
3173668274
Professional Enrollment ID
I20100128000931
Address ID
KY424501261PR215XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,718 FAMILY PRACTICE in KY

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Provider Addresses for TRISTAN K LINEBERRY (MD)

  • 37, Providence Avenue, Cumberland County, Maine, 04105, United States

    PROVIDENCE, KY 424500037

    Phone: (270) 667-7017

    Fax: (270) 667-9065

    Type: Mailing

  • 215, Main Street, Woodlawn, Pawtucket, Providence County, Rhode Island, 02860, United States

    PROVIDENCE, KY 424501261

    Phone: (270) 667-7017

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2010-01-28

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100128000931IFamily PracticeKYTBD

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.

Verify on CMS Revalidation Lookup Tool

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 42450)

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Provider's Procedures

TRISTAN K LINEBERRY (MD) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEKY81002Urinalysis, manual test2720
FAMILY MEDICINEKY85610Blood test, clotting time21623

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173668274View full group profile
NameSpecialtyState
Mental Health CounselorKY
Registered Dietitian Or Nutrition ProfessionalKY
Nurse PractitionerKY
-KY
Family PracticeKY
Nurse PractitionerKY
-KY
Nurse PractitionerKY
Nurse PractitionerKY
Nurse PractitionerOH

Reviews

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Frequently asked questions

What is the standard ID for TRISTAN K LINEBERRY (MD) in the U.S.?
In the U.S., TRISTAN K LINEBERRY (MD) is identified by NPI 1336245349.
Is TRISTAN K LINEBERRY (MD)'s NPI status active today?
Active status means TRISTAN K LINEBERRY (MD)'s NPI record is not deactivated in the public file.
What does the directory say TRISTAN K LINEBERRY (MD) does?
Insurance directories may phrase it differently, but here TRISTAN K LINEBERRY (MD) maps to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to TRISTAN K LINEBERRY (MD)?
TRISTAN K LINEBERRY (MD) is associated with Providence, Kentucky in the same public data insurers reference.
Why is information missing for TRISTAN K LINEBERRY (MD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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