DANIEL JAMES TIEDE


Address: 1200 Sixth Ave N, Centracare Clinic, St Cloud, MN 56303-2735
Phone: 3202525131

DANIEL JAMES TIEDE (NPI# 1306839949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306839949
Entity Type Individual
Full Name DANIEL JAMES TIEDE
Credential MD
Practice Address 1200 Sixth Ave N
Centracare Clinic
St Cloud
MN 56303-2735
Practice Telephone 3202525131
Practice Fax Number 3202402118
Mailing Telephone 3202525131
Mailing Fax Number 3202402118
Enumeration Date 2005-08-30
Last Update Date 2012-07-31
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
35523 MN Allopathic & Osteopathic Physicians
Y 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
35523 MN Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
BCBS 95D80T1 01
PREFERRED ONE 1025405 01
ARAZ GROUP/AMERICA'S PPO 1119213 01
MEDICA HEALTH PLANS 2500414 01
FIRST HEALTH PLAN 2114057 01
HEALTH PARTNERS HP31427 01
MEDICAL ASSISTANCE (MA) 852362200 01
MN 852362200 05
U-CARE 119337 01

Office Location

Street Address 1200 SIXTH AVE N
CENTRACARE CLINIC
City ST CLOUD
State MN
Zip Code 56303-2735

Providers in the same location

NPI Name Taxonomy Address Enumeration
1306848122 Bernard Rudolph Erickson Internal Medicine 1200 Sixth Ave N, Centracare Clinic, St Cloud, MN 56303-2735 2005-08-11
1255796918 Tiffany Nicole Sande Nurse Practitioner 1200 Sixth Ave N, St Cloud, MN 56303-2735 2015-12-23
1417327651 Larae A. Lymer Nurse Practitioner 1200 Sixth Ave N, St Cloud, MN 56303-2735 2015-09-30
1154799781 Sarah Catherine Babst Nurse Practitioner 1200 Sixth Ave N, St Cloud, MN 56303-2735 2015-09-14
1376933366 Milissa Sue Mcduffee Nurse Practitioner 1200 Sixth Ave N, Centracare Clinic River Campus/heart & Vascular Center, St Cloud, MN 56303-2735 2015-01-28
1174911127 Kristin Ann Gjerset Nurse Practitioner 1200 Sixth Ave N, Centracare Clinic, St Cloud, MN 56303-2735 2014-12-29
1306253323 Karen Rae Gozel Clinical Nurse Specialist 1200 Sixth Ave N, St Cloud, MN 56303-2735 2014-07-22
1093120131 Courtney Lynn Brever Physician Assistant 1200 Sixth Ave N, St Cloud, MN 56303-2735 2014-06-27
1104230879 Alyssa Marie Monson Dietitian, Registered 1200 Sixth Ave N, Centracare Clinic, St Cloud, MN 56303-2735 2014-06-20
1780023846 Patrick Wayne Odens Internal Medicine 1200 Sixth Ave N, St Cloud, MN 56303-2735 2013-06-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1841800463 Daniel P Lahr Radiologic Technologist St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 2020-08-07
1730798398 County of Stearns Case Management 705 Courthouse Square, St Cloud, MN 56303 2020-07-29
1669007126 Aflah Transportation LLC Non-emergency Medical Transport (VAN) 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 2020-03-05
1609420942 Stephanie Lynne Metzger Nurse Practitioner Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 2019-07-25
1306406947 Willow Tree Acupuncture LLC Acupuncturist 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 2019-06-17
1821553520 Alan Melvin Hoeper Nurse Anesthetist, Certified Registered Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 2019-02-06
1437644465 Brianna Larissa Justin Speech-Language Pathologist St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 2018-06-22
1780186486 Simplicity Health Pa Family Medicine 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 2018-03-08
1639682925 Dereje Beyene Respiratory Therapist, Certified 1406 15th Street North, Saint Cloud, MN 56303 2017-11-09
1740792761 Lisa Ann Horner Nurse Practitioner 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 2017-10-31
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Taxonomy Information

Taxonomy Code 207RI0011X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Interventional Cardiology

Taxonomy Definition

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine)

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1952880346 Allison Hall Internal Medicine Minneapolis Heart Institute, 920 E 28 St. #300, Minneapolis, MN 55407 2018-08-07
1578521555 Michael Jon Manoles Internal Medicine 516 Delaware St Se, Pwb, Clinic 3b, Cardiovascular Center, Minneapolis, MN 55455-0356 2006-05-01
1710962188 Mark W Erhard Internal Medicine 1560 Beam Ave, Suite B, Maplewood, MN 55109-1191 2005-12-08
1275081812 Claire Erinee Raphael Internal Medicine 200 1st St Sw, Rochester, MN 55905-0001 2016-09-12
1235578394 Amit Sharma Internal Medicine 640 Jackson St, Saint Paul, MN 55101-2502 2013-06-21
1023384211 Brett Oestreich Internal Medicine 420 Delaware St Se, Mmc 508, Minneapolis, MN 55455-0341 2012-04-01
1194014712 Stephen Alexander George Internal Medicine 640 Jackson St, Saint Paul, MN 55101 2011-04-05
1912223603 Rory Farnan Internal Medicine 1300 Anne St Nw, Bemidji, MN 56601-5103 2010-04-20
1558599712 Marat Yanavitski Internal Medicine 1700 University Ave W Fl 6, Saint Paul, MN 55104-3727 2009-06-26
1841436383 Marit Elise Thorsgard Internal Medicine 640 Jackson St, Saint Paul, MN 55101-2502 2009-01-06
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Competitor

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City ST CLOUD
Zip Code 56303

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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