Alden R Tetlie, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

27058 Issued in MN

Practice address

1540 Randolph Ave
Saint Paul, MN 55105-2535

Phone

(651) 699-8333

Fax

(651) 699-9257

NPI assigned

Aug 14, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Healtheast Medical Research Institute

  dba HealthEast Vadnais Heights Clinic

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  NPD

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1427061944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 SLOAN PL",
            "address_2": "SUITE 35",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172007",
            "telephone_number": "651-772-1572",
            "fax_number": "651-772-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 RANDOLPH AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052535",
            "telephone_number": "651-699-8333",
            "fax_number": "651-699-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETLIE",
        "first_name": "ALDEN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "27058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271872300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dylan Mathew Teske, DC
• Rachel Kristine Teslow, OTD, OTR/L
• Laura Tess, DNP, APRN, AGPCNP-C
• Debra Jean Tessier, RN, PHN
• Brett Walter Teten, MD
• Daniel Texidor, PA-C
• Thad Wilderson & Associates PA
• Thad Wilderson & Associates PA
• Thad Wilderson & Associates PA
• Christopher C Thaemert, D.C.

• Family Medicine Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.