GAYELAN TIETJE-ULRICH APRN
NPI 1477302263
Nurse Practitioner - Family in Middletown, CT

Q: What is Gayelan Tietje-ulrich's NPI number?

The NPI number for Gayelan Tietje-ulrich is 1477302263. It was assigned to this individual provider in the NPPES registry on May 15, 2024.

Q: What is Gayelan Tietje-ulrich's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since May 15, 2024PECOS Enrolled

675 MAIN ST, MIDDLETOWN, CT 06457(860) 347-6971 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 27, 2024, May 15, 2024 (2 updates tracked since 2024).

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About Gayelan Tietje-ulrich Aprn NPPES

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

GAYELAN TIETJE-ULRICH APRN (NPI 1477302263) is an individual family provider in Middletown, Connecticut, licensed in Connecticut (13390) and active in the NPI registry since May 2024. The provider is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477302263

Entity TypeIndividual

Primary Taxonomy363LF0000X

Provider Legal NameGAYELAN TIETJE-ULRICHCredential: APRN

Location Address675 MAIN STMiddletown, CT 06457-2732

Mailing Address19 Grand StMiddletown, CT 06457-2705

Phone(860) 347-6971

Sole ProprietorYes

Enumeration DateMay 15, 2024

Last NPPES UpdateJune 27, 20242 updates tracked since enumeration

NPPES CertifiedJune 27, 2024

✔ NPI 1477302263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CT · 13390

Also ListedRegistered NurseTaxonomy 163W00000X · License 196793 (CT)

675 MAIN ST, Middletown, CT 06457

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gayelan Tietje-ulrich Aprn 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.

Medicare Billing Reassignment

Medicare enrollment records show Gayelan Tietje-ulrich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Health Center Inc

Same address

Federally Qualified Health Center (FQHC)

675 MAIN ST
Middletown, CT 06457

Reassigned Medicare billing, Connecticut enrollment
390 clinicians in this Medicare group

NPI 1952591851 (860) 347-6971

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06457 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

$93.86 typical visit price

range $60.82 – $183.10

Typical copayment $23.46 (range $15.20 – $45.77)

Most-billed visit code 99203

Established Patient

$106.68 typical visit price

range $19.76 – $149.26

Typical copayment $26.67 (range $4.94 – $37.31)

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.

RACHEL MIRIAM BONAPARTE LCSW

Social Worker (Clinical)