Individual provider Active NPI

Kerry Anne Tiesi, CRNP

  • Family Nurse Practitioner
  • Pittsburgh, PA
National Provider Identifier
1306235239
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP014626 Issued in PA
Practice address
3600 Forbes Ave
Iroquois Building, Suite 304
Pittsburgh, PA 15213-3410
Phone
(412) 552-4301
NPI assigned
Jan 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP014626 PA Primary

Addresses

Primary practice location

3600 Forbes Ave
Iroquois Building, Suite 304
Pittsburgh, PA 15213-3410

Mailing address

3600 Forbes Ave
Iroquois Building, Suite 304
Pittsburgh, PA 15213-3410
Phone (412) 552-4301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20170427000071 PA Practitioner - Nurse Practitioner 6406159425 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Care Medical Associates LLC CurrentSince Mar 1, 2017 Accepting new patients
Pcma Palliative Division LLC CurrentSince Nov 5, 2018 Accepting new patients
Personal Care Medical Associates, LLC Past Accepting new patients

Locations

2000 Cliffmine Rd
Ste 500
Pittsburgh, PA 15275
Phone (724) 766-0025

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.

NPI Registry JSON

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1306235239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVE",
            "address_2": "IROQUOIS BUILDING, SUITE 304",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133410",
            "telephone_number": "412-552-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVE",
            "address_2": "IROQUOIS BUILDING, SUITE 304",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133410",
            "telephone_number": "412-552-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIESI",
        "first_name": "KERRY",
        "middle_name": "ANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.