Richard Elmer Tielker, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01024664A Issued in IN

Practice address

1515 Hobson Rd
Fort Wayne, IN 46805-4802

Phone

(260) 422-2481

Fax

(260) 969-3067

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• First Care Family Physicians, PC

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1659372274
  NPD (past) Authorized official

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1881709418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CAREW ST.",
            "address_2": "SUITE 1",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054765",
            "telephone_number": "260-373-9728",
            "fax_number": "260-373-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOBSON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054802",
            "telephone_number": "260-422-2481",
            "fax_number": "260-969-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIELKER",
        "first_name": "RICHARD",
        "middle_name": "ELMER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01024664A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00698399",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100369420A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000595591",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda Tiburcio
• Sonya Tichler, PTA
• Stewart Gregory Tidwell, MA, LMHC
• Jonathan Alvin Tiedeman, SCHOOL PSYCHOLOGIST
• Susan Marie Tielker-Sharpe, LCSW LMFT ACSW
• Kelsey E. Tiernon, MA
• Paige Tiernon
• Ian Tiffany, RBT
• Trisha Rose Tiffany, LPN
• Ryan Shane Tighe

• Family Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.