NPIMap

Individual provider Active NPI

Daniel James Tiede, MD

  • Interventional Cardiology Physician
  • Saint Cloud, MN
National Provider Identifier
1306839949
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
35523 Issued in MN
Practice address
1406 6TH Ave N
St Cloud, MN 56303
Phone
(320) 656-7020
Fax
(320) 255-5714
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35523 MN
Interventional Cardiology Physician 207RI0011X 35523 MN Primary

Addresses

Primary practice location

1406 6TH Ave N
St Cloud, MN 56303

Mailing address

1200 Sixth Ave N
Centracare Clinic
St Cloud, MN 56303-2735
Phone (320) 252-5131

Other identifiers 9

IdentifierTypeStateIssuer
HP31427OtherHEALTH PARTNERS
1119213OtherARAZ GROUP/AMERICA'S PPO
119337OtherU-CARE
2114057OtherFIRST HEALTH PLAN
1025405OtherPREFERRED ONE
2500414OtherMEDICA HEALTH PLANS
852362200MedicaidMN
852362200OtherMEDICAL ASSISTANCE (MA)
95D80T1OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090724000104 MN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8628121514 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
University of Minnesota Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centracare ClinicGroup PAC ID 2466363395, 800 clinicians
Astera HealthGroup PAC ID 2961395272, shared by 8 NPIs, 106 clinicians

Practice addresses (Care Compare)

101 Willmar Ave SW
Willmar, MN 56201-3556
Phone (320) 231-5000

111 17TH E Ave
Centracare Dialysis Alexandria
Alexandria, MN 56308-3703
Phone (800) 835-6652

1200 6TH Ave N
Saint Cloud, MN 56303-2735

1200 6TH N Ave
Saint Cloud, MN 56303-2735
Phone (320) 252-5131

1406 6TH Ave N
St Cloud, MN 56303-1901

1406 6TH Ave No
St Cloud, MN 56303-1901

1900 Centracare Cir
Saint Cloud, MN 56303-5000

20 9TH St SE
Centracare Health Sys Long Prairie
Long Prairie, MN 56347-1404
Phone (320) 732-2141

415 Jefferson St N
Wadena, MN 56482-1264
Phone (218) 631-7495

7418 Forthun Rd
Baxter, MN 56425-8702
Phone (218) 297-2048

PO Box
Chicago, IL 60673

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Astera Health CurrentSince Jan 1, 2020 Accepting new patients
Centracare Clinic Current Accepting new patients
Centracare Health System-NR LLC CurrentSince Sep 3, 2023 Accepting new patients
Mille Lacs Health System Current Accepting new patients
Mille Lacs Health System CurrentSince Jan 1, 2024 Accepting new patients
Mille Lacs Health System Current Accepting new patients
Astera Health CurrentSince Jan 1, 2020 Accepting new patients
Mille Lacs Health System Current Accepting new patients
Centracare Health System-NR LLC CurrentSince Sep 3, 2023 Accepting new patients
Centracare Clinic CurrentSince May 5, 2009 Accepting new patients
Mille Lacs Health System CurrentSince Jan 1, 2024 Accepting new patients
Centracare Clinic CurrentSince May 5, 2009 Accepting new patients
Centracare Health System-NR LLC Current Accepting new patients
Centracare Clinic Past Accepting new patients
Centracare Clinic Past Accepting new patients
Mayo Clinic Past Accepting new patients

Locations

12800 Rolling Ridge Rd
Becker, MN 55308
Phone (763) 261-7000

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

27378 State Highway 18
Garrison, MN 56450
Phone (320) 692-5599

824 N 11th St
Montevideo, MN 56265
Phone (320) 269-8877

1013 Hart Blvd
Monticello, MN 55362
Phone (763) 271-2303

200 Elm St N
Onamia, MN 56359
Phone (320) 532-2750

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1900 Centracare Cir
Saint Cloud, MN 56303
Phone (320) 252-2422

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

301 Becker Ave SW
Willmar, MN 56201
Phone (320) 231-4120

Interoperability endpoints

  • Direct secure messaging: dtiede1615@direct.centracare.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1306839949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SIXTH AVE N",
            "address_2": "CENTRACARE CLINIC",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "563032735",
            "telephone_number": "320-252-5131",
            "fax_number": "320-240-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 6TH AVE N",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-656-7020",
            "fax_number": "320-255-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDE",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "35523",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MN",
            "license": "35523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP31427",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARAZ GROUP/AMERICA'S PPO",
            "identifier": "1119213",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U-CARE",
            "identifier": "119337",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PLAN",
            "identifier": "2114057",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1025405",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA HEALTH PLANS",
            "identifier": "2500414",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "852362200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE (MA)",
            "identifier": "852362200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "95D80T1",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.