NPIMap

Individual provider Active NPI

Jeffrey S. Tiahrt, PA-C

  • Physician Assistant
  • Sartell, MN
National Provider Identifier
1912183476
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10396 Issued in MN
Practice address
1901 Connecticut Ave. S
Sartell, MN 56377
Phone
(320) 259-4100
Fax
(320) 257-5523
NPI assigned
Jan 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10396 MN Primary

Addresses

Primary practice location

1901 Connecticut Ave. S
Sartell, MN 56377

Mailing address

1901 Connecticut Ave. S
Sartell, MN 56377
Phone (320) 259-4100

Other practice location 1

3315 Roosevelt Rd Ste 200B
Saint Cloud, MN 56301-9687
Phone (320) 259-4100

Other identifiers 2

IdentifierTypeStateIssuer
P00463430OtherMNRR MEDICAID
970003410MedicaidMN

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
I20080409000179 MN Practitioner - Physician Assistant 9032296462 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 4TH Ave SE
Glenwood, MN 56334-1820

301 Hwy 65 S
Mora, MN 55051-1899

415 Jefferson St N
Wadena, MN 56482-1264

415 Jefferson St N
Wadena, MN 56482-1296

612 S Sibley Ave Meeker Memorial Hospital
Litchfield, MN 55355-3398

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.31 of 100Reported as group
Quality
74.55
Promoting interoperability
79
Improvement activities
40
Cost
83.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
408MNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Welia Health CurrentSince Jun 3, 2025 Accepting new patients
County of Meeker CurrentSince Aug 9, 2025 Accepting new patients
Glacial Ridge Hospital District CurrentSince Oct 1, 2024 Accepting new patients
Welia Health Current Accepting new patients
Welia Health CurrentSince Jun 3, 2025 Accepting new patients
Astera Health CurrentSince Aug 6, 2023 Accepting new patients
County of Meeker CurrentSince Aug 1, 2024 Accepting new patients
Glacial Ridge Hospital District CurrentSince Oct 1, 2024 Accepting new patients
Glacial Ridge Hospital District Past Accepting new patients

Locations

417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157

10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157

612 S Sibley Ave
Litchfield, MN 55355
Phone (320) 693-3242

301 Highway 65 S
Mora, MN 55051
Phone (320) 225-3317

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

3315 Roosevelt Rd
Ste 200B
Saint Cloud, MN 56301
Phone (320) 259-4100

1901 Connecticut Ave S
Sartell, MN 56377
Phone (320) 259-4100

415 Jefferson St N
Wadena, MN 56482
Phone (218) 631-3510

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c
  • Direct secure messaging: jtiahrt930@direct.centracare.com
  • Direct secure messaging: jtiahrt@stcloudortho1831.srs-direct.com

Organizations & group practices 11

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 11

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": "1200355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1912183476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 CONNECTICUT AVE. S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "56377",
            "telephone_number": "320-259-4100",
            "fax_number": "320-257-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 CONNECTICUT AVE. S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "56377",
            "telephone_number": "320-259-4100",
            "fax_number": "320-257-5523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3315 Roosevelt Rd Ste 200B",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "MN",
            "postal_code": "563019687",
            "country_code": "US",
            "telephone_number": "320-259-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIAHRT",
        "first_name": "JEFFREY",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-15",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICAID",
            "identifier": "P00463430",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "970003410",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.