MRS. TIESHAU MIDDLEBROOKS (APN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063583375
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,574 NURSE PRACTITIONER in NJ
Provider Addresses for MRS. TIESHAU MIDDLEBROOKS (APN)
1200 S CHURCH ST STE 20
MOUNT LAUREL, NJ 080542936
Phone: (609) 937-3491
Fax: (609) 853-0221
Type: Location
319, South Harrison Avenue, Capitol Hill, Edgewater Park Township, Burlington County, New Jersey, 08010, United States
EDGEWATER PARK, NJ 080102121
Phone: (609) 239-1371
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $45.
Total Amount is formed as General ($45) + Research ($0) + Ownership ($0) = $45.
Last reported payment date: 2023-05-30 • Largest payer in this snapshot: Vanda Pharmaceuticals Inc. ($30).
Total Amount
$45
General + Research + Ownership
Payments
3
Total payment records
General Amount
$45
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Vanda Pharmaceuticals Inc. | $30 |
| ABBVIE INC. | $15 |
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: 2016-05-16
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20160516001211 | I | Nurse Practitioner | NJ | 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 08054)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | NJ | 90792 | Psychiatric diagnostic evaluation with medical services | 19 | 19 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Qualified Speech Language Pathologist | NJ | |
| Nurse Practitioner | OH | |
| Mental Health Counselor | FL | |
| Mental Health Counselor | NJ | |
| Clinical Psychologist | NJ |
Reviews
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