Individual provider Active NPI

Daniel Martin Tieva, M.D.

  • Family Medicine Physician
  • Anchorage, AK
National Provider Identifier
1639464050
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8150 Issued in AK
Practice address
821 N St Ste 102
Anchorage, AK 99501-3285
Phone
(253) 844-4327
NPI assigned
Jun 14, 2011
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8150 AK Primary

Addresses

Primary practice location

821 N St Ste 102
Anchorage, AK 99501-3285

Mailing address

917 Pacific Ave Ste 600
Tacoma, WA 98402-4437
Phone (253) 844-4327

Other practice location 1

3260 Providence Dr Ste C436
Anchorage, AK 99508-4661
Phone (907) 212-2273

Other practice location 2

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 729-3300

Other identifiers 1

IdentifierTypeStateIssuer
1615645MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dtieva825110@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140917001663 TX Practitioner - Family Practice 5890932792 Reassigns benefits to 3 organizations
I20170824001658 AK Practitioner - Family Practice 5890932792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platinum Peaks Healthcare PCGroup PAC ID 0648784157, 45 clinicians
Pacific Medical Specialty GroupGroup PAC ID 2365838364, 56 clinicians

Practice addresses (Care Compare)

821 N St
Suite 102
Anchorage, AK 99501-3285
Phone (253) 844-4327

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8150AKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jul 1, 2024 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Pacific Medical Specialty Group CurrentSince Aug 8, 2024 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Jul 31, 2014 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Southcentral Foundation Current Accepting new patients
Platinum Peaks Healthcare PC CurrentSince Aug 18, 2025 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Providence Health & Services Washington Past Accepting new patients
Korsin Healthcare LLC Past Accepting new patients
Providence Health & Services Washington Past Accepting new patients
Centennial SNF Healthcare LLC Past Accepting new patients
Korsin Healthcare LLC Past Accepting new patients
Care Center Anchorage Inc. Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4320 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-0000

4501 Diplomacy Dr
Anchorage, AK 99508
Phone (800) 478-3343

7033 E Tudor Rd
Anchorage, AK 99507
Phone (907) 729-0000

821 N St
Ste 102
Anchorage, AK 99501
Phone (253) 844-4327

3020 S Union Ave
Tacoma, WA 98409
Phone (253) 844-4327

917 Pacific Ave
Ste 600
Tacoma, WA 98402
Phone (253) 232-7495

Interoperability endpoints

  • Direct secure messaging: dtieva825110@ak.providencedirect.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Centennial Post AcuteAnchorage, AK, CCN 025025A Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Aug 1, 2024
Aug 1, 2024
Polaris Transitional CareAnchorage, AK, CCN 025018 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF
Mar 1, 2025
Mar 1, 2025
Polaris Extended CareAnchorage, AK, CCN 025036 Skilled nursing facility Managing Control - Governing Body
Adp of the SNF
Mar 1, 2025
Mar 1, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 30

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 30

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1639464050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 PACIFIC AVE STE 600",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024437",
            "telephone_number": "253-844-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N ST STE 102",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995013285",
            "telephone_number": "253-844-4327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3260 Providence Dr Ste C436",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995084661",
            "country_code": "US",
            "telephone_number": "907-212-2273",
            "fax_number": "907-212-6065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4315 Diplomacy Dr",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995085926",
            "country_code": "US",
            "telephone_number": "907-729-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIEVA",
        "first_name": "DANIEL",
        "middle_name": "MARTIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "8150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1615645",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dtieva825110@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "1389 Huffman Park Dr Ste 202",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995153534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.