Breck Michael Tiernan, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

16005321 Issued in IL

Practice address

350 Houbolt Rd
Suite 104
Joliet, IL 60431-8305

Phone

(815) 553-0990

Fax

(815) 553-0991

NPI assigned

May 3, 2007

Last updated

Oct 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Broeckert Michael Tiernan Other name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Breck Tiernan PCGroup PAC ID 6901961465, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

60 of 100Reported as group

Quality

20

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Breck Tiernan PC

  dba Advanced Foot and Ankle Center of Joliet

  • Foot & Ankle Surgery Podiatrist
  • Joliet, IL
  • NPI 1730354382
  Medicare reassignment Care Compare group NPD Authorized official
• Anderson Tiernan Podiatry PC

  dba Advanced Foot and Ankle Center of Orland Park

  • Foot & Ankle Surgery Podiatrist
  • Orland Park, IL
  • NPI 1538590013
  Authorized official Same address or phone
• Andersontiernan Inc

  • Podiatrist
  • Schaumburg, IL
  • NPI 1992091219
  Authorized official Same address or phone
• Andersontiernan, Inc

  dba Advanced Foot & Ankle Centers of Illinois

  • Non-Pharmacy Dispensing Site
  • Joliet, IL
  • NPI 1518210673
  NPD (past) Authorized official

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1861614380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 HOUBOLT RD",
            "address_2": "SUITE 104",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604318305",
            "telephone_number": "815-553-0990",
            "fax_number": "815-553-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HOUBOLT RD",
            "address_2": "SUITE 104",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604318305",
            "telephone_number": "815-553-0990",
            "fax_number": "815-553-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNAN",
        "first_name": "BRECK",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "16005321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROECKERT",
            "last_name": "TIERNAN",
            "middle_name": "MICHAEL",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Charles Thompson
• Danielle Joseah Thompson, PHARMD
• Heather Thompson, PT
• Jennifer Thompson, FNP-C
• Robert Thorsness, M.D.
• Sharon Marie Tierney, PTA
• Veveca A Tikasingh, L.C.S.W
• Samantha Jean Tippy, PSYD
• Ann E Todd, O.D.
• Olga Toerber

• Foot & Ankle Surgery Podiatrist in Joliet, IL
• Providers in Joliet, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.