Stephanie Tietz

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1032760 Issued in TX

Practice address

3007 Gardencrest LN
Dickinson, TX 77539-4579

Phone

(713) 898-6445

NPI assigned

Mar 18, 2021

Last updated

Mar 18, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Texas Medical Branch at Galveston, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aic Urgent Care. PLLCGroup PAC ID 5890956650, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Aic Urgent Care. PLLC

  • Urgent Care Clinic/Center
  • La Marque, TX
  • NPI 1962788125
  Medicare reassignment Care Compare group NPD
• Aic Primary Care, PLLC

  dba Affinity Immediate Care, LLC

  • Primary Care Clinic/Center
  • La Marque, TX
  • NPI 1326324567
  NPD (past)

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1083290217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 GARDENCREST LN",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "775394579",
            "telephone_number": "713-898-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 GARDENCREST LN",
            "city": "DICKINSON",
            "state": "TX",
            "postal_code": "775394579",
            "telephone_number": "713-898-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIETZ",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1032760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Texas United Anesthesia PLLC
• Texas United Anesthesia PLLC
• The James Health Wellness & Training Services LLC
• Theresa a Rameden, MD, PA
• Carolyn Denice Thompson, APRN-CNP
• Jennifer Kristen Todd, PA-C
• Mandie Ann Toland, FNP
• Rachel Tolentino, LPC
• Glenna Rae Tolley, RN FNP-C
• Angelique S Torres, AU.D

• Family Nurse Practitioner in Dickinson, TX
• Providers in Dickinson, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.