Mark Tieman, MD, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

179172 Issued in NY

Legal business name

MARK TIEMAN, MD, PC

Practice address

356 Veterans Memorial Hwy
Commack, NY 11725-4343

Phone

(631) 858-0400

Fax

(631) 543-2785

NPI assigned

Nov 3, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mark Daryl Tieman, MDNPI 1154494003

Title

President

Phone

(631) 424-9844

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Daryl Tieman, M.D.

  • Internal Medicine Physician
  • Commack, NY
  • NPI 1154494003
  Medicare reassignment NPD Authorized official
• Cindy Demetriou

  • Adult Health Nurse Practitioner
  • Commack, NY
  • NPI 1033592589
  Medicare reassignment NPD
• Denise Feldman, MSSW

  • Clinical Social Worker
  • Commack, NY
  • NPI 1942505847
  NPD (past)

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1821375940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 COPPERDALE LN",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432523",
            "telephone_number": "631-424-9844",
            "fax_number": "631-543-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 VETERANS MEMORIAL HWY",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254343",
            "telephone_number": "631-858-0400",
            "fax_number": "631-543-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK TIEMAN, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "TIEMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DARYL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-424-9844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "179172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Mardiney
• Susan M Marfoglio, NP
• Celeste Marino
• Michael Raymond Marinucci, P.T.
• Mark a. Mandel, D.C., P.C.
• Lisa A. Markowitz, D.D.S.
• Marra Glick Applied Behavior Solutions
• Christine Marra, PH.D
• Lauren Marra
• Christine Marren, FNP-C

• Primary Care Clinic/Center in Commack, NY
• Providers in Commack, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.