DR. DOUGLAS N TIETJEN (MD) – Specialist, NPI 1679522700
Specialist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
271 UROLOGY in MO
Provider Addresses for DR. DOUGLAS N TIETJEN (MD)
301 NE MULBERRY ST
SUITE 200
LEES SUMMIT, MO 640865818
Phone: (816) 524-1007
Fax: (816) 524-1988
Type: Location
10701, Nall Avenue, Overland Park, Johnson County, Kansas, 66211, United States
SUITE 100
OVERLAND PARK, KS 662111231
Phone: (913) 341-7985
Fax: (913) 341-7988
Type: Mailing
451 NW MURRAY RD
LEES SUMMIT, MO 640811425
Phone: (816) 524-1007
Fax: (816) 524-1988
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 34 Open Payments records for all available years, with a total value of $705.
Total Amount is formed as General ($705) + Research ($0) + Ownership ($0) = $705.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ABBVIE INC. ($148).
Total Amount
$705
General + Research + Ownership
Payments
34
Total payment records
General Amount
$705
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-03-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050714000470 | I | Urology | MO | TBD |
| I20120313000600 | I | Urology | KS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J0585 | Injection, onabotulinumtoxina, 1 unit | 1,700 | 14 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 506 | 437 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 305 | 231 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 270 | 234 | $0 |
| 81002 | Urinalysis, manual test | 207 | 154 | $0 |
Insurance plans in this area (ZIP 64086)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | OR | |
| Physician Assistant | KS | |
| U R O L O G Y | KS | |
| - | KS | |
| U R O L O G Y | MO | |
| U R O L O G Y | MO | |
| U R O L O G Y | KS | |
| Nurse Practitioner | MO | |
| Physician Assistant | KS | |
| U R O L O G Y | MO |
Reviews
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