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JACOB ANDREW TIEDE
NPI 1194529479
Student in an Organized Health Care Education/Training Program in Missoula, MT

Active since April 03, 2025PECOS Enrolled
401 RAILROAD ST W, MISSOULA, MT 59802(406) 258-4789(406) 258-4732 Get Directions Write a Review

NPPES record last updated: April 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jacob Andrew Tiede NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB ANDREW TIEDE (NPI 1194529479) is an individual student in an organized health care education/training program in Missoula, Montana and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194529479
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACOB ANDREW TIEDE
Location Address401 RAILROAD ST WMissoula, MT 59802-4178
Mailing Address401 Railroad St WMissoula, MT 59802-4178 · (406) 258-4789 · Fax (406) 258-4732
Phone(406) 258-4789
Fax(406) 258-4732
Sole ProprietorNo
Enumeration DateApril 3, 2025
NPPES CertifiedApril 2, 2025
✔ NPI 1194529479 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
401 RAILROAD ST W, Missoula, MT 59802
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Andrew Tiede is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARK CHRISTOPHER WAYNE LCSW
Social Worker (Clinical)
401 RAILROAD ST W
MISSOULA, MT 59802
Missoula County (406) 830-5584
MS. KAITLYN NINA BOSSHARDT LMSW
Social Worker (Clinical)
401 RAILROAD ST W
MISSOULA, MT 59802
Missoula County (406) 258-4789
ELLEN JEAN BLUETT PHD
Psychologist (Clinical)
401 RAILROAD ST W
MISSOULA, MT 59802
Missoula County (406) 258-4789
NED F VASQUEZ MD
Family Medicine
401 RAILROAD ST W
MISSOULA, MT 59802
Missoula County (406) 258-4789
RYAN HINSHAW RN
Registered Nurse
401 RAILROAD ST W
MISSOULA, MT 59802
Missoula County (406) 258-4789
ANN MAUREEN O'CONNOR PA C
Physician Assistant (Medical)
401 RAILROAD ST W
MISSOULA, MT 59802
Missoula County (406) 258-4789
ARIEL FILLMORE MD
Family Medicine
401 RAILROAD ST W
MISSOULA, MT 59802
Missoula County (406) 258-4789
JESTINE TERYSSA MACDONALD MD
Family Medicine
401 RAILROAD ST W
MISSOULA, MT 59802
Missoula County (406) 258-4789

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Tiede's NPI number?

The NPI number for Jacob Tiede is 1194529479. It was assigned to this individual provider in the NPPES registry on April 3, 2025.

Where is Jacob Tiede located?

Jacob Tiede practices at 401 Railroad St W, Missoula, MT 59802. The listed phone number is (406) 258-4789.

What is Jacob Tiede's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Tiede enrolled in Medicare?

Yes. Jacob Tiede is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Tiede was last updated on April 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.