Mr Shelby Rigdon Tieken, AGACNP-BC in Fort Worth, TX

Mr Shelby Rigdon Tieken, AGACNP-BC is a medicare enrolled "Nurse Practitioner - Acute Care" in Fort Worth, Texas. He graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Dallas Pulmonary And Critical Care, Pa and his current practice location is 1500 S Main St, Fort Worth, Texas. You can reach out to his office (for appointments etc.) via phone at (817) 702-1100.

Mr Shelby Rigdon Tieken is licensed to practice in Texas (license number 1028643) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1255924064.

Contact Information

	Mr Shelby Rigdon Tieken, AGACNP-BC
	1500 S Main St, Fort Worth, TX 76104-4917
	(817) 702-1100
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Shelby Rigdon Tieken
Gender	Male
Speciality	Nurse Practitioner
Experience	4 Years
Location	1500 S Main St, Fort Worth, Texas
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Shelby Rigdon Tieken graduated from nursing school in 2020

NPI Data:

NPI Number: 1255924064
Provider Enumeration Date: 02/12/2021
Last Update Date: 01/10/2024

Medicare PECOS Information:

PECOS PAC ID: 4183025398
Enrollment ID: I20210625000626

Medical Identifiers

Medical identifiers for Mr Shelby Rigdon Tieken such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1255924064	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	1028643 (Texas)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Baylor Scott & White Medical Center Grapevine	Grapevine, TX	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Dallas Pulmonary And Critical Care, Pa	2163679200	148

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Shelby Rigdon Tieken allows following entities to bill medicare on his behalf.

Entity Name	Dallas Pulmonary & Critical Care, Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235402728 PECOS PAC ID: 2163679200 Enrollment ID: O20120824000752

Entity Name	Acclaim Physician Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780076562 PECOS PAC ID: 4587963582 Enrollment ID: O20160426000707

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Shelby Rigdon Tieken is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Shelby Rigdon Tieken, AGACNP-BC 200 W Magnolia Ave Ste 201, Ft Worth, TX 76104-7657 Ph: (817) 702-2977	Mr Shelby Rigdon Tieken, AGACNP-BC 1500 S Main St, Fort Worth, TX 76104-4917 Ph: (817) 702-1100

Reviews and Comments

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Lacy Pitchford, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1263 W Rosedale St Ste 200, Fort Worth, TX 76104 Phone: 817-336-4896 Fax: 817-332-2805
Mary Agnes Johnson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1400 8th Ave, Fort Worth, TX 76104 Phone: 817-922-7070
Susan Akberzie, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1401 W Pulaski St, Fort Worth, TX 76104 Phone: 682-885-8012 Fax: 682-885-8014

Mr Shelby Rigdon Tieken, AGACNP-BC - Medicare Nurse Practitioner in Fort Worth, TX