Luke Jon Tietz, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12255 Issued in MN

Practice address

504 6TH Ave NW
New Prague, MN 56071-1709

Phone

(952) 257-8800

NPI assigned

Jun 16, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ltietz1374298@ehrdirect.mayoclinicmsg.org

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.

• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422
  Medicare reassignment NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Waseca, MN
  • NPI 1518494251
  NPD

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1235707092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 6TH AVE NW",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 6TH AVE NW",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711709",
            "telephone_number": "952-257-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIETZ",
        "first_name": "LUKE",
        "middle_name": "JON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "12255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ltietz1374298@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "504 6th Ave NW",
            "city": "New Prague",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560711709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Marie Thelemann, PHARMD
• Thro Company
• Amanda Mariah Thurmes, OD
• John Edward Tieben, M.D.
• Kristin E. Tiegs, MD
• Courtney Marie Toavs, MSW, LICSW
• Julia Tucker
• Nichole Elizabeth Tuma, M.S., CCC-SLP
• Jeremy Michael Tupy, DC
• Colleen Marie Turner, PT

• Physical Therapist in New Prague, MN
• Providers in New Prague, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.