Fredric Tietz, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD166601 Issued in OR

Practice address

61250 SE Coombs PL
Bend, OR 97702-3704

Phone

(541) 706-5930

Fax

(541) 706-5931

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Emergency Medicine

Education

University of Southern California Keck School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Charles Health System IncGroup PAC ID 8729111513, 379 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

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 and National Provider Directory roles.

• St. Charles Health System, Inc.

  • Family Medicine Physician
  • Bend, OR
  • NPI 1023331303
  Medicare reassignment Care Compare group NPD
• St. Charles Health System, Inc.

  • Critical Access Hospital
  • Madras, OR
  • NPI 1356389894

  Emergency Medicine

  Medicare reassignment NPD
• St. Charles Health System, Inc.

  • Critical Access Hospital
  • Prineville, OR
  • NPI 1710160445

  Emergency Medicine

  Medicare reassignment NPD
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447

  Emergency Medicine

  Medicare reassignment NPD
• St. Charles Health System, Inc.

  • Rehabilitation Hospital Unit
  • Bend, OR
  • NPI 1154343150
  NPD
• St. Charles Health System, Inc.

  • Specialist
  • Bend, OR
  • NPI 1700697935
  NPD
• Tahoe Emergency Physicians Medical Corporation

  • Emergency Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1104937408
  NPD (past)

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

• Cascade Healthcare Community Inc

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1467486829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6096",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086096",
            "telephone_number": "541-548-8131",
            "fax_number": "541-706-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61250 SE COOMBS PL",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023704",
            "telephone_number": "541-706-5930",
            "fax_number": "541-706-5931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1253 NW Canal Blvd",
            "address_2": "St. Charles Medical Center Redmond",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "97756",
            "country_code": "US",
            "telephone_number": "541-548-8131",
            "fax_number": "541-706-3765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIETZ",
        "first_name": "FREDRIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G50497",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD166601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ftietz18200@secure.stcharleshealthcare.org",
            "affiliation": "N",
            "address_1": "61250 SE Coombs Pl",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977023704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Thrive Through Play LLC
• Michelle Tibbs, OTD
• Caroline Gentry Tien, LCSW, MSW
• Raymond Tien, M.D.
• Rosalie Tierney, RD
• Natasha M Tiffany, M.D.
• Jamie Tigner, PA-C
• Katherine Emma Tiller I, R.N.
• Molly Ann Tilley, M.D.
• Timm Family Dental

• Emergency Medicine Physician in Bend, OR
• Providers in Bend, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.