NPIMap

Individual provider Active NPI

John Edward Tieben, M.D.

  • Family Medicine Physician
  • New Prague, MN
National Provider Identifier
1902093768
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
50997 Issued in MN
Practice address
301 2ND St NE
New Prague, MN 56071
Phone
(952) 758-4431
NPI assigned
Sep 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 50997 MN Primary

Addresses

Primary practice location

301 2ND St NE
New Prague, MN 56071

Mailing address

301 2ND St NE
New Prague, MN 56071-1709
Phone (952) 587-4431

Other practice location 1

1805 Hennepin Ave. North
Glencoe Regional Health Services
Glencoe, MN 55336
Phone (320) 864-3121

Other practice location 2

1805 Hennepin Ave. North
Glencoe Regional Health Services
Glencoe, MN 55336
Phone (320) 864-3121

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jtieben91892@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080814000355 MN Practitioner - Family Practice 2163597857 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, shared by 6 NPIs, 658 clinicians

Practice addresses (Care Compare)

301 2ND St NE
New Prague, MN 56071-1709
Phone (952) 758-4431

Hospital & facility affiliations

  • Adara Home Health Inc Home health agency, Buffalo, MN, CCN 248056
  • St Croix Hospice Hospice, Albert Lea, MN, CCN 241613
  • Mayo Clinic Health System New Prague Hospital, New Prague, MN, CCN 241361
  • Mayo Clinic Health System - Mankato Hospital, Mankato, MN, CCN 240093
  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
  • Mayo Clinic Health System - Waseca Hospital, Waseca, MN, CCN 241345
  • Mayo Clinic Health System New Prague Nursing home, CCN 24Z361

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jun 1, 2016 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jun 1, 2016 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

1000 1st Dr NW
Austin, MN 55912
Phone (507) 433-7351

32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

212 10th Ave NE
New Prague, MN 56071
Phone (952) 758-4431

301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

625 N Jackson Ave
Springfield, MN 56087
Phone (507) 723-3523

501 State St N
Waseca, MN 56093
Phone (507) 835-1210

Interoperability endpoints

  • Direct secure messaging: jtieben91892@ehrdirect.mayoclinicmsg.org

Organizations & group practices 12

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1902093768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 2ND ST NE",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711709",
            "telephone_number": "952-587-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 2ND ST NE",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "56071",
            "telephone_number": "952-758-4431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1805 Hennepin Ave. North",
            "address_2": "Glencoe Regional Health Services",
            "address_purpose": "LOCATION",
            "city": "Glencoe",
            "state": "MN",
            "postal_code": "55336",
            "country_code": "US",
            "telephone_number": "320-864-3121",
            "fax_number": "218-529-9120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1805 Hennepin Ave. North",
            "address_2": "Glencoe Regional Health Services",
            "address_purpose": "LOCATION",
            "city": "Glencoe",
            "state": "MN",
            "postal_code": "55336",
            "country_code": "US",
            "telephone_number": "320-864-3121",
            "fax_number": "218-529-9120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIEBEN",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "50997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jtieben91892@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "301 2nd St NE",
            "city": "New Prague",
            "state": "MN",
            "country_code": "US",
            "postal_code": "56071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Prague, MN

Sources for this page

Verify at the official NPI Registry.