| Myles Eldon Tieszen, MD | |
|
1601 Sioux Valley Dr, Luverne, MN 56156 | |
| (507) 283-4476 | |
| (507) 283-9086 |
| Full Name | Myles Eldon Tieszen |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 37 Years |
| Location | 1601 Sioux Valley Dr, Luverne, Minnesota |
| 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 |
|---|---|---|---|
| 1063464683 | NPI | - | NPPES |
| 46045455601 | Medicaid | NE | |
| 7300264 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 3813 (South Dakota) | Secondary |
| 208600000X | Surgery | 38654 (Iowa) | Secondary |
| 208600000X | Surgery | 64861 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sanford Chamberlain Medical Center | Chamberlain, SD | Hospital |
| Sanford Sheldon Medical Center | Sheldon, IA | Hospital |
| Great Plains Health | North platte, NE | Hospital |
| Sanford Medical Center Aberdeen | Aberdeen, SD | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sanford Health Network | 6800707100 | 364 |
| Sanford Health Network | 6800707100 | 364 |
| Sanford Health Network | 6800707100 | 364 |
| North Platte Nebraska Hospital Corporation | 6507856697 | 236 |
| Entity Name | Sanford Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255353934 PECOS PAC ID: 0244143824 Enrollment ID: O20040216001158 |
| Entity Name | Sanford Health Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134787930 PECOS PAC ID: 6800707100 Enrollment ID: O20040324000654 |
| Entity Name | Sanford Health Network |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1841200623 PECOS PAC ID: 6800707100 Enrollment ID: O20061104000716 |
| Entity Name | Sanford Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093090342 PECOS PAC ID: 8325950215 Enrollment ID: O20200527001874 |
| Mailing Address | Practice Location Address |
|---|---|
| Myles Eldon Tieszen, MD 1601 Sioux Valley Dr, Luverne, MN 56156-4500 Ph: (507) 283-4476 | Myles Eldon Tieszen, MD 1601 Sioux Valley Dr, Luverne, MN 56156 Ph: (507) 283-4476 |