Kierstyn Tietgens, MA, CCC-SLP is a medicare enrolled "Speech-language Pathologist" provider in High Springs, Florida. Her current practice location is
19478 Nw 230th St, High Springs, Florida. You can reach out to her office (for appointments etc.) via phone at
(352) 455-1942.
Kierstyn Tietgens is licensed to practice in Florida (license number SA17854) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114612116.
Healthcare Provider's Profile
Full Name | Kierstyn Tietgens |
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Gender | Female |
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Speciality | Speech-language Pathologist |
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Location | 19478 Nw 230th St, High Springs, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1114612116
- Provider Enumeration Date: 04/06/2023
- Last Update Date: 04/06/2023
Medicare PECOS Information:
- PECOS PAC ID: 6103282736
- Enrollment ID: I20230523003529
Medical Identifiers
Medical identifiers for Kierstyn Tietgens such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1114612116 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
235Z00000X | Speech-language Pathologist | SA17854 (Florida) | Primary |
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. Kierstyn Tietgens allows following entities to bill medicare on her behalf.
Provider Name | Speak Up Virtual Speech Therapy Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1407437569 PECOS PAC ID: 5890195788 Enrollment ID: O20210615001074 |
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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. Kierstyn Tietgens 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 |
Kierstyn Tietgens, MA, CCC-SLP 19478 Nw 230th St, High Springs, FL 32643-4160 Ph: () - | Kierstyn Tietgens, MA, CCC-SLP 19478 Nw 230th St, High Springs, FL 32643-4160 Ph: (352) 455-1942 |
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