SPENCER TIETJEN (AU.D.) – Audiologist, NPI 1851699003

SPENCER TIETJEN (AU.D.) is a healthcare provider. based in Logan, Utah. specializing in Audiologist. They hold the professional credentials AU.D.. The NPI Number for SPENCER TIETJEN (AU.D.) is 1851699003

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
SPENCER TIETJEN (AU.D.)
NPI
1851699003
Phone
(435) 753-7880
Address
2380 N 400 E Ste D
Enumeration Date
11 March 2011
Last Update Date
24 June 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4357537880
Graduation Year
2011 (15 years ago)
PAC ID
8921271958
Group Practice PAC ID
0547203945
Professional Enrollment ID
I20111107000790
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:15State licenses:0Digital endpointsOther names

Provider Addresses for SPENCER TIETJEN (AU.D.)

  • 2380 N 400 E Ste D

    Logan, UT 843411756

    Phone: (435) 753-7880

    Type: Location

  • 2380 N 400 E STE D

    LOGAN, UT 843411756

    Phone: (435) 753-7880

    Type: Mailing

  • 2245 N 400 E

    STE 301

    LOGAN, UT 843411892

    Phone: (435) 753-7880

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2011-11-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111107000790IQualified AudiologistUTTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84341)

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Provider's Procedures

SPENCER TIETJEN (AU.D.) performs procedures in Audiologist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
QUALIFIED AUDIOLOGISTUT92567Eardrum testing using ear probe206177

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0547203945View full group profile

Reviews

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Frequently asked questions

Where can patients find SPENCER TIETJEN (AU.D.)'s NPI?
You can confirm SPENCER TIETJEN (AU.D.) with NPI 1851699003; it appears in the national provider directory.
Is SPENCER TIETJEN (AU.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does SPENCER TIETJEN (AU.D.) treat or focus on?
Patients typically see SPENCER TIETJEN (AU.D.) under the specialty Audiologist. Clinical services aligned with this taxonomy classification.
What location shows for SPENCER TIETJEN (AU.D.)?
We surface Logan, Utah for SPENCER TIETJEN (AU.D.) based on available NPPES addresses.
How can I contact SPENCER TIETJEN (AU.D.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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