Mark Daryl Tieman, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

179172 Issued in NY

Practice address

356 Veterans Memorial Hwy
Commack, NY 11725-4332

Phone

(631) 858-0400

Fax

(631) 543-2785

NPI assigned

Nov 16, 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 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

Albert Einstein College of Medicine of Yeshiva University, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Mark Tieman, MD, PC

  • Primary Care Clinic/Center
  • Commack, NY
  • NPI 1821375940
  Medicare reassignment NPD Authorized official
• Vytaliz Medical

  • Internal Medicine Physician
  • New City, NY
  • NPI 1568831105
  NPD

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154494003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 COPPERDALE LN",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432523",
            "telephone_number": "631-858-0400",
            "fax_number": "631-543-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 VETERANS MEMORIAL HWY",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254332",
            "telephone_number": "631-858-0400",
            "fax_number": "631-543-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEMAN",
        "first_name": "MARK",
        "middle_name": "DARYL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "179172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.D. LICENSE NUMBER",
            "identifier": "179172",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karthika Thirugnanam, RDN
• Susan Thomas, P.T
• Daniel Raphael Thompson
• Kamille Thompson
• Jillian Thorsen, LMSW
• Stephanie Tinio, D.P.T
• Pooja Tolani, DDS
• Melvyn A Topel, DDS
• Scott Raymond Torns, D.C.
• Kerry Ann Torrell, PH.D.

• Internal Medicine Physician in Commack, NY
• Providers in Commack, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.