Allan Don Tiedrich, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MA41589 Issued in NJ

Practice address

1304 South Avenue
Plainfield, NJ 07062

Phone

(908) 769-7999

Fax

(908) 769-5816

NPI assigned

Nov 30, 2006

Last updated

Jul 23, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NJ

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

State licenses

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.

• Allan D. Tiedrich, M.D. P.a.

  • Physical Medicine & Rehabilitation Physician
  • Plainfield, NJ
  • NPI 1053642538
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1174690242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 SOUTH AVENUE",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "07062",
            "telephone_number": "908-769-7999",
            "fax_number": "908-769-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 SOUTH AVENUE",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "07062",
            "telephone_number": "908-769-7999",
            "fax_number": "908-769-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDRICH",
        "first_name": "ALLAN",
        "middle_name": "DON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "MA41589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Plainfield, NJ
• Providers in Plainfield, NJ by specialty
• Physical Medicine & Rehabilitation Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.