TIFFANY MERRILL KETZLE (APRN ANP-C) – Nurse Practitioner, NPI 1982719837
Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for TIFFANY MERRILL KETZLE (APRN ANP-C)
4537, Eldorado Drive, Plano, Collin County, Texas, 75093, United States
PLANO, TX 750935406
Phone: (972) 867-0129
Type: Mailing
3901 W 15th St
Plano, TX 750757738
Phone: (972) 566-6800
Type: Location
3901 W 15TH ST
PLANO, TX 750757738
Phone: (972) 867-0129
Type: Mailing
Preston Road, Plano, Collin County, Texas, 75024, United States
SUITE 300
PLANO, TX 750242688
Phone: (972) 608-2025
Fax: (972) 608-2032
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $52.
Total Amount is formed as General ($52) + Research ($0) + Ownership ($0) = $52.
Last reported payment date: 2023-10-26 • Largest payer in this snapshot: Medtronic, Inc. ($52).
Total Amount
$52
General + Research + Ownership
Payments
1
Total payment records
General Amount
$52
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $52 |
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: 2005-03-01
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 |
|---|---|---|---|---|
| I20050301000106 | I | Nurse Practitioner | TX | 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 75093)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O S U R G E R Y | TX | |
| N E U R O S U R G E R Y | MO | |
| N E U R O S U R G E R Y | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| N E U R O S U R G E R Y | TX | |
| Nurse Practitioner | TX | |
| N E U R O S U R G E R Y | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX |
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