Active NPI
John S Tiedeman, MD
- Anesthesiology Physician
- Charlottesville, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 0101243857
- Practice address
- 459 Locust Ave
Charlottesville, VA 22902-4808 - Phone
- (434) 296-7733
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 0101243857 | VA | Primary |
Addresses
Primary practice location
459 Locust Ave
Charlottesville, VA 22902-4808
Mailing address
311 10TH St NE
Charlottesville, VA 22902-5316
Phone (434) 296-7733
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Virginia School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 507-1000
Hospital & facility affiliations
- Sentara Martha Jefferson Hospital
- Sentara Norfolk General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101243857 | VA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SMG Anesthesia Specialists LLC | Anesthesiology | Current | Accepting new patients |
| Commonwealth Anesthesia Associates, P.C. | Anesthesiology | Current | Accepting new patients |
| Uva Community Health Medical Group, LLC | Current | Accepting new patients |
Locations
500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000
4105 Lewis and Clark Dr
Charlottesvle, VA 22911
501 Sunset Ln
Culpeper, VA 22701
Phone (540) 829-4100
10800 Midlothian Tpke
Ste 265
North Chesterfield, VA 23235
Phone (804) 594-1383
7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088
2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000
Organizations & group practices 3
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.
-
- Anesthesiology Physician
- Virginia Beach, VA
- NPI 1518205004
-
- Anesthesiology Physician
- Richmond, VA
- NPI 1548275308
-
- Multi-Specialty Clinic/Center
- Charlottesville, VA
- NPI 1598475741
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Charlottesville, VA
- NPI 1346248663
-
- General Acute Care Hospital
- Norfolk, VA
- NPI 1437119310
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214956800000",
"number": "1104047307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 10TH ST NE",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229025316",
"telephone_number": "434-296-7733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "459 LOCUST AVE",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229024808",
"telephone_number": "434-296-7733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIEDEMAN",
"first_name": "JOHN",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2008-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "VA",
"license": "0101243857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlottesville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.
- 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.