MR. FREDERICK R. TIENCKEN RPA-C
NPI 1396053617
Physician Assistant - Medical in Ridgewood, NJ

Q: What is Frederick Tiencken's NPI number?

The NPI number for Frederick Tiencken is 1396053617. It was assigned to this individual provider in the NPPES registry on September 21, 2010.

Q: What is Frederick Tiencken's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Active since September 21, 2010PECOS EnrolledAccepts Medicare Assignment

1200 E RIDGEWOOD AVE STE 200, RIDGEWOOD, NJ 07450(201) 327-8600(201) 327-8225 Get Directions Write a Review

NPPES record last updated: August 21, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Mr. Frederick R. Tiencken Rpa-c NPPES

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

MR. FREDERICK R. TIENCKEN RPA-C (NPI 1396053617) is an individual medical provider in Ridgewood, New Jersey, licensed in New Jersey (25MP00264400) and active in the NPI registry since September 2010. He is enrolled in Medicare PECOS, is affiliated with Overlook Medical Center, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1396053617

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. FREDERICK R. TIENCKENCredential: RPA-C

Location Address1200 E RIDGEWOOD AVE STE 200Ridgewood, NJ 07450-3937

Mailing Address1200 E Ridgewood Ave Ste 200Ridgewood, NJ 07450-3937 · (201) 327-8600 · Fax (201) 327-8225

Phone(201) 327-8600

Fax(201) 327-8225

Sole ProprietorYes

Medical School CMSOtherGraduated 2010

Enumeration DateSeptember 21, 2010

Last NPPES UpdateAugust 21, 2025

NPPES CertifiedAugust 21, 2025

✔ NPI 1396053617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Licenses✔ Licensed in NJ · 25MP00264400✔ Licensed in NY · 014271

1200 E RIDGEWOOD AVE STE 200, Ridgewood, NJ 07450

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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 and accepts Medicare assignment

Mr. Frederick R. Tiencken Rpa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335364504

PECOS Enrollment IDI20140701001467

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

72 services61 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

47 services47 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Overlook Medical Center

Acute Care Hospitals · Summit, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310051

Location99 Beauvoir AvenueSummit, NJ 07901 · Union County

Emergency services Birthing friendly

Cooperman Barnabas Medical Center

Acute Care Hospitals · Livingston, NJ

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310076

Location94 Old Short Hills RoadLivingston, NJ 07039 · Essex County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 8

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

WILLIAM GILLIGAN P.T.

Physical Therapist