Kelly Eugene Tjelmeland, M D

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

J7860 Issued in TX

Practice address

4220 Bull Creek Rd
Austin, TX 78731-6026

Phone

(512) 617-7500

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17821/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-myrecord.cerner.com/r4/b4348b5b-bd9c-4bea-a3a3-0691137fbf46/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tjelmeland Plastic Surgery, P. a.

  • Plastic Surgery Physician
  • Austin, TX
  • NPI 1710071832
  NPD Authorized official
• Mid Coast Medical Center Crockett Inc

  • Rural Health Clinic/Center
  • Crockett, TX
  • NPI 1003303983
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1003900119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 BULL CREEK RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 BULL CREEK RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316026",
            "telephone_number": "512-617-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TJELMELAND",
        "first_name": "KELLY",
        "middle_name": "EUGENE",
        "credential": "M D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "J7860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110753404",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL NUMBER",
            "identifier": "8AQ830",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kara Titus, PA-C
• Shawnee Dean Titus
• Trenton Daniel Titus, DPT
• Julius Walter Tiu-Lim, O.D.
• Tjelmeland Plastic Surgery, P. a.
• TJF Optometric Holdings P.L.L.C
• Vincent M. Tjia, MD
• TK Clinic LLC
• TMC Provider Group PLLC
• TMC Provider Group PLLC

• Plastic Surgery Physician in Austin, TX
• Providers in Austin, TX by specialty
• Plastic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.