Douglas Tietjen (NPI# 1679522700, PAC ID# 7113983800) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1679522700 |
| PAC ID by PECOS | 7113983800 |
| Professional Enrollment ID | I20050714000470 |
| Full Name | Douglas Tietjen |
| Organization Legal Name | KANSAS CITY UROLOGY CARE PA |
| Address |
17525 Medical Ctr Pkwy Independence MO 64057-1824 |
| Phone Number | 8169943150 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE |
| Graduation Year | 1993 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 9032006853 |
| Number of Group Practice Members | 50 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 260216 | SAINT LUKE'S EAST HOSPITAL |
| 260138 | ST LUKES HOSPITAL OF KANSAS CITY |
| 260190 | LEE'S SUMMIT MEDICAL CENTER |
| 170182 | MENORAH MEDICAL CENTER |
| 260097 | WESTERN MISSOURI MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 17525 Medical Ctr Pkwy, Independence, MO 64057-1824 | 8169943150 | KANSAS CITY UROLOGY CARE PA |
| 301 Ne Mulberry, Suite 200, Lees Summit, MO 64086-6017 | 8165241007 | KANSAS CITY UROLOGY CARE PA |
| 2750 Clay Edwards Dr, Suite 500, North Kansas City, MO 64116-3258 | 8165241007 | KANSAS CITY UROLOGY CARE PA |
| 10701 Nall Ave, Suite 100, Overland Park, KS 66211-1244 | 9133417985 | KANSAS CITY UROLOGY CARE PA |
| Organization Legal Name | KANSAS CITY UROLOGY CARE PA |
| Physicians | 43 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Abbie M O'brien | Physician Assistant | Kansas City Urology Care Pa | 301 Ne Mulberry, Suite 200, Lees Summit, MO 64086-6017 |
| James S Magera Jr. | Urology | Kansas City Urology Care Pa | 17525 Medical Ctr Pkwy, Independence, MO 64057-1824 |
| Jason W Anast | Urology | Kansas City Urology Care Pa | 20375 W 151st St, Suite 270, Olathe, KS 66061-5360 |
| Laura L Roy | Nurse Practitioner | Kansas City Urology Care Pa | 10701 Nall Ave, Suite 100, Overland Park, KS 66211-1244 |
| Allison O Serrano | Physician Assistant | Kansas City Urology Care Pa | 421 S Maple St, Garnett, KS 66032-1334 |
| Samuel Kuykendall | Urology | Kansas City Urology Care Pa | 301 Ne Mulberry, Suite 200, Lees Summit, MO 64086-6017 |
| Kent L Haggard | Urology | Kansas City Urology Care Pa | 10701 Nall Ave, Suite 100, Overland Park, KS 66211-1244 |
| Daris A King | Physician Assistant | Kansas City Urology Care Pa | 20375 W 151st St, Suite 270, Olathe, KS 66061-5360 |
| Christian A Hettinger | Urology | Kansas City Urology Care Pa | 301 Ne Mulberry, Suite 200, Lees Summit, MO 64086-6017 |
| Sarah M Eatherly | Physician Assistant | Kansas City Urology Care Pa | 10701 Nall Ave, Suite 100, Overland Park, KS 66211-1244 |
| Street Address |
17525 MEDICAL CTR PKWY |
| City | INDEPENDENCE |
| State | MO |
| Zip | 64057-1824 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James S Magera Jr. | Urology | Kansas City Urology Care Pa | 17525 Medical Ctr Pkwy, Independence, MO 64057-1824 |
| Andrew David Wright | Urology | Kansas City Urology Care Pa | 17525 Medical Ctr Pkwy, Independence, MO 64057-1824 |
| David A Deer | Radiation Oncology | Kansas City Urology Care Pa | 17525 Medical Ctr Pkwy, Independence, MO 64057-1824 |
| Kenneth P Collins | Urology | Kansas City Urology Care Pa | 17525 Medical Ctr Pkwy, Independence, MO 64057-1824 |
| Gregory J Horwitz | Urology | Kansas City Urology Care Pa | 17525 Medical Ctr Pkwy, Independence, MO 64057-1824 |
| Kenon S Qamar | Radiation Oncology | Kansas City Urology Care Pa | 17525 Medical Ctr Pkwy, Independence, MO 64057-1824 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James W Lindsey | Chiropractic | 2333s 291 Hwy, Independence, MO 64057 | |
| Christopher Wise | Orthopedic Surgery | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Andre M Jakoi | Orthopedic Surgery | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Courtney Adams | Physician Assistant | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Jeffrey A Krempec | Orthopedic Surgery | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Nathan J Kiewiet | Orthopedic Surgery | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Janese B Surber | Nurse Practitioner | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Nikki A Vogel | Physician Assistant | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Zachary V Roberts | Orthopedic Surgery | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Alexa Kyl Moberly | Physician Assistant | Orthopedic Health of Kansas City PC | 19550 W 39th St, Suite 410, Independence, MO 64057-0001 |
| Find all physicians in zip 64057 | |||
| City | INDEPENDENCE |
| Zip Code | 64057 |
| Specialty | UROLOGY |
| City + Specialty | INDEPENDENCE + UROLOGY |
Please comment or provide details below to improve the information on Douglas Tietjen.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.