Mae Lynne Tietje, MSN, RN, APN, AGNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

26NJ01069800 Issued in NJ

Practice address

3830 Atlantic Ave
Atlantic City, NJ 08401-6080

Phone

(609) 345-6000

NPI assigned

Nov 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Atlanticare Physician Group PAGroup PAC ID 8527953660, 506 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada Home Health Care, Inc. Home health agency, Egg Harbor Township, NJ, CCN 317066
• Patient Care Home health agency, Egg Harbor Township, NJ, CCN 317072
• Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

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.

• Atlanticare Physician Group PA

  • Clinic/Center
  • Egg Harbor Township, NJ
  • NPI 1093829608
  Medicare reassignment Care Compare group NPD
• Atlanticare Physician Group

  dba AtlantiCare Urgent Care

  • Clinical Social Worker
  • Egg Harbor Township, NJ
  • NPI 1881618494
  NPD
• Atlanticare Physician Group, PA

  dba AtlantiCare Urgent Care

  • Urgent Care Clinic/Center
  • Galloway, NJ
  • NPI 1003820622
  NPD
• Atlanticare Physician Group

  dba AtlantiCare Internal Medicine

  • Primary Care Clinic/Center
  • Ventnor City, NJ
  • NPI 1194839910
  NPD (past)

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

• Atlanticare Regional Medical Center

  • General Acute Care Hospital
  • Pomona, NJ
  • NPI 1013919315
  Care Compare affiliation
• Bayada Home Health Care, Inc.

  • Home Health Agency
  • Egg Harbor Township, NJ
  • NPI 1922820901
  Care Compare affiliation
• LHCG CXLV, LLC

  dba AtlantiCare Home Health

  • Home Health Agency
  • Egg Harbor Township, NJ
  • NPI 1154884401
  Care Compare affiliation

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

{
    "created_epoch": "1604707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604707200000",
    "number": "1730780479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 DEERFIELD DR",
            "city": "MAYS LANDING",
            "state": "NJ",
            "postal_code": "083304924",
            "telephone_number": "609-204-6792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 ATLANTIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016080",
            "telephone_number": "609-345-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIETJE",
        "first_name": "MAE",
        "middle_name": "LYNNE",
        "credential": "MSN, RN, APN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-07",
        "last_updated": "2020-11-07",
        "certification_date": "2020-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ01069800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Arc of Atlantic County, Inc.
• The Arc of Atlantic County, Inc.
• The Five Before Five Foundation, Inc.
• The Parrucche Garbiere Wigs Studio, Limited Liability Co. (wigs by garbiere)
• Leah Elizabeth Thomas, MD
• Melissa Ashley Till, LCSW
• Avian L. Tisdale, MD
• Junko Todaka
• William Upton Todd IV, M.D.
• Ashley Tolliver

• Primary Care Nurse Practitioner in Atlantic City, NJ
• Providers in Atlantic City, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2020; 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.