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KENNETH TIETJEN M.D.
NPI 1245765817
Pediatrics in Brooklyn, NY

Active since April 20, 2017PECOS Enrolled
2601 OCEAN PKWY, BROOKLYN, NY 11235(718) 616-3205 Get Directions Write a Review

NPPES record last updated: August 25, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 25, 2021, Apr 20, 2017 (2 updates tracked since 2017).

About Kenneth Tietjen M.d. NPPES

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

KENNETH TIETJEN M.D. (NPI 1245765817) is an individual pediatrics provider in Brooklyn, New York, licensed in New York (307219) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245765817
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameKENNETH TIETJENCredential: M.D.
Location Address2601 OCEAN PKWYBrooklyn, NY 11235-7745
Mailing Address2601 Ocean Pkwy Rm 901Brooklyn, NY 11235-7745 · (718) 616-3205
Phone(718) 616-3205
Sole ProprietorYes
Enumeration DateApril 20, 2017
Last NPPES UpdateAugust 25, 20212 updates tracked since enumeration
NPPES CertifiedAugust 25, 2021
✔ NPI 1245765817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NY · 307219
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2601 OCEAN PKWY, Brooklyn, NY 11235
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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)

Kenneth Tietjen M.d. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11235 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

LEYLA DAHBALI PA
Physician Assistant
2601 OCEAN PKWY, 8TH FLOOR ROOM 8N53
BROOKLYN, NY 11235
Kings County (718) 616-3260
DIMITRI LIVSHITS DO
Emergency Medicine
2601 OCEAN PKWY
BROOKLYN, NY 11235
Kings County (718) 616-3000
SAMIRA DUJA
Pharmacist
2601 OCEAN PKWY, 2N1D - INPATIENT PHARMACY
BROOKLYN, NY 11235
Kings County (718) 616-3636
RAJWOANA AHMED PHARMD
Pharmacist
2601 OCEAN PKWY
BROOKLYN, NY 11235
Kings County (718) 616-3000
RACHEL PASTERNAK
Physician Assistant
2601 OCEAN PKWY
BROOKLYN, NY 11235
Kings County (718) 616-3000
ARISTOTLE JOHN LYSSIKATOS DDS
Dentist (General Practice)
2601 OCEAN PKWY
BROOKLYN, NY 11235
Kings County (718) 319-4339
MS. ELIZABETH A CLEARY BS
Pharmacist
2601 OCEAN PKWY, PHARMACY DEPARTMENT
BROOKLYN, NY 11235
Kings County (718) 616-4080
DR. OLUFEMI OGUNSEMI DDS
Student in an Organized Health Care Education/Training Program
2601 OCEAN PKWY
BROOKLYN, NY 11235
Kings County (718) 449-1889

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 Kenneth Tietjen's NPI number?

The NPI number for Kenneth Tietjen is 1245765817. It was assigned to this individual provider in the NPPES registry on April 20, 2017.

Where is Kenneth Tietjen located?

Kenneth Tietjen practices at 2601 Ocean Pkwy, Brooklyn, NY 11235. The listed phone number is (718) 616-3205.

What is Kenneth Tietjen's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kenneth Tietjen enrolled in Medicare?

Yes. Kenneth Tietjen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Tietjen was last updated on August 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.