Active NPI
Douglas N Tietjen, MD
- Urology Physician
- Lees Summit, MO
National Provider Identifier
1679522700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 118291
- Practice address
- 451 NW Murray Rd
Lees Summit, MO 64081-1425 - Phone
- (816) 524-1007
- Fax
- (816) 524-1988
- NPI assigned
- May 8, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 118291 | MO | Primary |
| Urology Physician | 208800000X | 0428228 | KS |
Addresses
Primary practice location
451 NW Murray Rd
Lees Summit, MO 64081-1425
Mailing address
451 NW Murray Rd
Lees Summit, MO 64081-1425
Phone (816) 524-1007
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 205101 | Medicaid | MO | |
| 340016722 | Other | RR MEDICARE | |
| 25977052 | Other | MO | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO, KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- University of Missouri, Kansas City, School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10701 Nall Ave
Suite 100
Overland Park, KS 66211-1244
Phone (913) 341-7985
17525 Medical Ctr Pkwy
Independence, MO 64057-1824
Phone (816) 994-3150
4321 Washington St
Suite 5300
Kansas City, MO 64111-5931
Phone (816) 531-1234
4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-2000
451 NW Murray Rd
Lees Summit, MO 64081-1425
Phone (816) 524-1007
8551 Bluejacket St
Overland Park, KS 66214-1656
Hospital & facility affiliations
- St Lukes Hospital of Kansas City
- Saint Luke'S East Hospital
- Lee'S Summit Medical Center
- Menorah Medical Center
- Western Missouri Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 22 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Luke'S Physician Group Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Kansas City, MO
- NPI 1093263717
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lees Summit, MO
- NPI 1225085871
-
- General Acute Care Hospital
- Lees Summit, MO
- NPI 1053353490
-
- General Acute Care Hospital
- Kansas City, MO
- NPI 1063494177
-
- General Acute Care Hospital
- Kansas City, MO
- NPI 1932642972
-
- General Acute Care Hospital
- Liberty, MO
- NPI 1275926198
-
- General Acute Care Hospital
- Warrensburg, MO
- NPI 1083601330
-
- General Acute Care Hospital
- Overland Park, KS
- NPI 1255378337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776902400000",
"number": "1679522700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 NW MURRAY RD",
"city": "LEES SUMMIT",
"state": "MO",
"postal_code": "640811425",
"telephone_number": "816-524-1007",
"fax_number": "816-524-1988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 NW MURRAY RD",
"city": "LEES SUMMIT",
"state": "MO",
"postal_code": "640811425",
"telephone_number": "816-524-1007",
"fax_number": "816-524-1988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIETJEN",
"first_name": "DOUGLAS",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-08",
"last_updated": "2026-04-23",
"certification_date": "2026-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MO",
"license": "118291",
"primary": true
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "KS",
"license": "0428228",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "205101",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "340016722",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "25977052",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lees Summit, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.