Active NPI
Nathan Tiedeken, M.D.
- Orthopaedic Surgery Physician
- West Reading, PA
National Provider Identifier
1487965893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- MT197680
- Practice address
- 301 S 7TH Ave
Suite 365
West Reading, PA 19611-1410 - Phone
- (570) 624-4777
- Fax
- (570) 624-4778
- NPI assigned
- Jun 30, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MT197680 | PA | Primary |
Addresses
Primary practice location
301 S 7TH Ave
Suite 365
West Reading, PA 19611-1410
Mailing address
48 Tunnel Rd
Suite 203
Pottsville, PA 17901-3875
Phone (570) 624-4777
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160809000354 | PA | Practitioner - Orthopedic Surgery | 2264726694 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Temple University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Phoenix Rehabilitation and Health Services IncIntegrated Medical Group P C
Practice addresses (Care Compare)
2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238
48 Tunnel Rd
Suite 203
Pottsville, PA 17901-3885
Phone (570) 624-4777
Hospital & facility affiliations
- Reading Hospital
- Schuylkill Medical Center - South Jackson Street
- Penn State Health St. Joseph
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 106 |
| Removal of tissue | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT197680 | PA | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Medical Group P C | Current | Accepting new patients |
Locations
82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455
48 Tunnel Rd
Ste 203
Pottsville, PA 17901
Phone (570) 622-5455
2211 Quarry Dr
Ste E52
Reading, PA 19609
Phone (610) 372-7200
Interoperability endpoints
- ntiedeken@imgpc.medentdirect.com
Organizations & group practices 7
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.
-
- Podiatrist
- Pottsville, PA
- NPI 1053695148
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Pottsville, PA
- NPI 1700381076
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Reading, PA
- NPI 1881341303
-
- Chiropractor
- State College, PA
- NPI 1245588946
-
- Physical Therapist
- Cranberry Township, PA
- NPI 1720084155
-
- Surgery Physician
- Pottsville, PA
- NPI 1417911819
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rural Acute Care Hospital
- Pottsville, PA
- NPI 1235138405
Hospital
-
- General Acute Care Hospital
- Pottsville, PA
- NPI 1427050376
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470182400000",
"number": "1487965893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 TUNNEL RD",
"address_2": "SUITE 203",
"city": "POTTSVILLE",
"state": "PA",
"postal_code": "179013875",
"telephone_number": "570-624-4777",
"fax_number": "570-624-4778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S 7TH AVE",
"address_2": "SUITE 365",
"city": "WEST READING",
"state": "PA",
"postal_code": "196111410",
"telephone_number": "570-624-4777",
"fax_number": "570-624-4778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIEDEKEN",
"first_name": "NATHAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-30",
"last_updated": "2016-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "PA",
"license": "MT197680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Reading, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.