Leslie Catherine Tietjen

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

202004995NP-PP Issued in OR

Practice address

520 Medical Center Dr Ste 200
Medford, OR 97504-4314

Phone

(541) 930-7222

Fax

(541) 930-7220

NPI assigned

Sep 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Asante Physician PartnersGroup PAC ID 8325206246, 227 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Asante Physician Partners

  • Family Medicine Physician
  • Medford, OR
  • NPI 1922381326
  Medicare reassignment Care Compare group NPD
• Southern Oregon Cardiology LLC

  • Cardiovascular Disease Physician
  • Medford, OR
  • NPI 1033444781
  Medicare reassignment NPD
• Southern Oregon Wellness Clinic, LLC

  • Primary Care Clinic/Center
  • Medford, OR
  • NPI 1538446315
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1164071858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR",
            "address_2": "STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044314",
            "telephone_number": "541-930-7260",
            "fax_number": "541-930-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL CENTER DR STE 200",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044314",
            "telephone_number": "541-930-7222",
            "fax_number": "541-930-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIETJEN",
        "first_name": "LESLIE",
        "middle_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "7010",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202004995NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Tice, MD
• Michael Orion Tice, PHARMD.
• Cory Sean Tichauer, ND
• Caryn Tierney, LAC
• Ryan Tierney
• Brandon D. Tilton, PT
• Michelle Marie Tilton
• Caraway L Timmins, CNM, MSN
• Tina Timmons
• Timothy R. Driver, MD P.C.

• Nurse Practitioner in Medford, OR
• Providers in Medford, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.