Individual provider Active NPI

Kenneth K Tieu, M.D.

  • Surgery Physician
  • Melbourne, FL
National Provider Identifier
1902122781
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME114362 Issued in FL
Practice address
8725 N Wickham Rd
Melbourne, FL 32940-2239
Phone
(321) 434-9230
Fax
(321) 434-9269
NPI assigned
Apr 19, 2010
Last updated
Dec 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME114362 FL Primary

Addresses

Primary practice location

8725 N Wickham Rd
Melbourne, FL 32940-2239

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-9230

Other practice location 1

1223 Gateway Dr Ste 2B
Melbourne, FL 32901-2607
Phone (321) 434-9230

Other practice location 2

1810 Eldron Blvd SE
Palm Bay, FL 32909-6831
Phone (321) 434-9230

Other identifiers 2

IdentifierTypeStateIssuer
117762000MedicaidFL
GQ944YOtherFLFL MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121109000486 FL Practitioner - General Surgery 5395939888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Pennsylvania State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians

Practice addresses (Care Compare)

1421 Malabar Rd NE
Suite 220
Palm Bay, FL 32907-2559
Phone (321) 434-8226

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.79 of 100Reported as apm
Quality
86.5
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)31
Upper gastrointestinal (GI) endoscopy for acid reflux156
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME114362FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC CurrentSince Mar 31, 2014 Accepting new patients
Health First Medical Group, LLC Surgery CurrentSince Mar 31, 2014 Accepting new patients

Locations

699 W Cocoa Beach Cswy
Ste 404
Cocoa Beach, FL 32931
Phone (321) 868-2778

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

1223 Gateway Dr
Ste 2B
Melbourne, FL 32901
Phone (321) 361-5614

8725 N Wickham Rd
Ste 302
Melbourne, FL 32940
Phone (321) 434-9230

1421 Malabar Rd NE
Ste 220
Palm Bay, FL 32907
Phone (321) 434-8226

1810 Eldron Blvd SE
Palm Bay, FL 32909
Phone (321) 312-3466

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

8725 N Wickham Rd
Ste 200
Viera, FL 32940
Phone (321) 434-9230

Interoperability endpoints

  • Direct secure messaging: ktieu25605@epicdirect.hf.org

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1271635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1902122781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-434-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402239",
            "telephone_number": "321-434-9230",
            "fax_number": "321-434-9269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1223 Gateway Dr Ste 2B",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329012607",
            "country_code": "US",
            "telephone_number": "321-434-9230",
            "fax_number": "321-434-9269",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1810 Eldron Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329096831",
            "country_code": "US",
            "telephone_number": "321-434-9230",
            "fax_number": "321-434-9269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIEU",
        "first_name": "KENNETH",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-19",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME114362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117762000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE",
            "identifier": "GQ944Y",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.