| Dr Douglas N Tietjen, MD | |
|
451 Nw Murray Rd, Lees Summit, MO 64081-1425 | |
| (816) 524-1007 | |
| (816) 524-1988 |
| Full Name | Dr Douglas N Tietjen |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 33 Years |
| Location | 451 Nw Murray Rd, Lees Summit, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679522700 | NPI | - | NPPES |
| 205101 | Medicaid | MO | |
| 340016722 | Other | RR MEDICARE | |
| 25977052 | Other | MO | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 118291 (Missouri) | Primary |
| 208800000X | Urology | 0428228 (Kansas) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Lukes Hospital Of Kansas City | Kansas city, MO | Hospital |
| Lee's Summit Medical Center | Lees summit, MO | Hospital |
| Saint Luke's East Hospital | Lees summit, MO | Hospital |
| Menorah Medical Center | Overland park, KS | Hospital |
| Western Missouri Medical Center | Warrensburg, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kansas City Urology Care Pa | 9032006853 | 73 |
| Kansas City Urology Care Pa | 9032006853 | 73 |
| Entity Name | Kansas City Urology Care Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528024676 PECOS PAC ID: 9032006853 Enrollment ID: O20040304001071 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Douglas N Tietjen, MD 451 Nw Murray Rd, Lees Summit, MO 64081-1425 Ph: (816) 524-1007 | Dr Douglas N Tietjen, MD 451 Nw Murray Rd, Lees Summit, MO 64081-1425 Ph: (816) 524-1007 |
Dr. William Todd Johnson, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 301 Ne Mulberry St Ste 200, Lees Summit, MO 64086 Phone: 816-524-1007 Fax: 816-524-1988 | |
Dr. Paul Joseph Guidos Iii, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 451 Nw Murray Rd, Lees Summit, MO 64081 Phone: 816-524-1007 Fax: 816-524-1988 |