TIFFANY BRECKENRIDGE (LICSW) – Clinical Social Worker, NPI 1194206664

TIFFANY BRECKENRIDGE (LICSW) is a healthcare provider. based in Rochester, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 23032 (MN). The NPI Number for TIFFANY BRECKENRIDGE (LICSW) is 1194206664

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
TIFFANY BRECKENRIDGE (LICSW)
NPI
1194206664
Phone
(507) 266-8043
Address
200 1ST ST SW
Enumeration Date
23 August 2018
Last Update Date
28 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2022 (4 years ago)
PAC ID
4486906518
Group Practice PAC ID
0840665774
Professional Enrollment ID
I20181017002902
Address ID
MN560013762MA100XXSTXX304

Contacts

Secure Messaging
tbreckenridge131795@ehrdirect.mayoclinicmsg.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness85
Years active:7State licenses:1Other namesUpdated within 12 months

2,310 CLINICAL SOCIAL WORKER in MN

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Provider Addresses for TIFFANY BRECKENRIDGE (LICSW)

  • 1st Street Southwest, Rochester, Olmsted County, Minnesota, 55903, United States

    ROCHESTER, MN 559050002

    Phone: (507) 266-8043

    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)

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: 2018-10-17

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
I20181017002902IClinical Social WorkerMNTBD

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 55905)

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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: 0840665774View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Mental Health CounselorMN
Mental Health CounselorMN
Nurse PractitionerMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

How do payers reference TIFFANY BRECKENRIDGE (LICSW)?
For TIFFANY BRECKENRIDGE (LICSW), use NPI 1194206664 as the unique 10-digit identifier.
Would TIFFANY BRECKENRIDGE (LICSW) appear as active to a payer?
You can treat TIFFANY BRECKENRIDGE (LICSW) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to TIFFANY BRECKENRIDGE (LICSW)?
TIFFANY BRECKENRIDGE (LICSW)'s specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What locale is associated with TIFFANY BRECKENRIDGE (LICSW)?
Directory geography for TIFFANY BRECKENRIDGE (LICSW) centers on Rochester, Minnesota.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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