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CARLY MARIE TIEDKE PA-C
NPI 1740807189
Physician Assistant - Surgical in Aurora, CO

Active since July 01, 2020PECOS EnrolledAccepts Medicare Assignment
13123 E 16TH AVE, AURORA, CO 80045(720) 777-1234 Get Directions Write a Review

NPPES record last updated: February 4, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 4, 2025, Jan 26, 2022, Nov 2, 2021 and 1 more (4 updates tracked since 2020).

About Carly Marie Tiedke Pa-c NPPES

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

CARLY MARIE TIEDKE PA-C (NPI 1740807189) is an individual surgical provider in Aurora, Colorado, licensed in Colorado (PA.0006324) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS, maintains a secondary practice location in Denver, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1740807189
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameCARLY MARIE TIEDKECredential: PA-C
Location Address13123 E 16TH AVEAurora, CO 80045-7106
Mailing AddressPo Box 110429Aurora, CO 80042-0429
Phone(720) 777-1234
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJuly 1, 2020
Last NPPES UpdateFebruary 4, 20254 updates tracked since enumeration
NPPES CertifiedFebruary 4, 2025
✔ NPI 1740807189 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in CO · PA.0006324
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA.0006324 (CO)
13123 E 16TH AVE, Aurora, CO 80045
Open in Google Maps ↗

Secondary Practice Location 1

Location 12055 N High St Ste 370Denver, CO 80205-5545 · Phone (303) 839-6001 · Fax (303) 839-6033

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, UnitedHealthcare.Insurance ›

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

Carly Marie Tiedke Pa-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 ID2466877725
PECOS Enrollment IDI20200803003072
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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
3 suppliers17 claims17 services$24.82 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers13 claims13 services$64.52 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$33.28 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

LISA WANGER PA
Physician Assistant
13123 E 16TH AVE
AURORA, CO 80045
Adams County (720) 777-1234
JOYCE MARIE GIBBONS PA C
Physician Assistant
13123 E 16TH AVE, B145
AURORA, CO 80045
Adams County (720) 777-6652
DAVID ECKHARDT PA
Physician Assistant
13123 E 16TH AVE
AURORA, CO 80045
Adams County (720) 777-1234
RAJEEV VIBHAKAR MD
Pediatrics (Pediatric Hematology-Oncology)
13123 E 16TH AVE
AURORA, CO 80045
Adams County (720) 777-1234
STANLEY LOFTNESS MD
Anesthesiology
13123 E 16TH AVE
AURORA, CO 80045
Adams County (720) 777-1234
SEAN O'LEARY MD
Pediatrics (Pediatric Infectious Diseases)
13123 E 16TH AVE
AURORA, CO 80045
Adams County (720) 777-1234
FREDERICK SUCHY M.D.
Pediatrics (Pediatric Gastroenterology)
13123 E 16TH AVE, THE CHILDRENS HOSPITAL
AURORA, CO 80045
Adams County (720) 777-1234
DUNCAN WILCOX MD
Urology (Pediatric Urology)
13123 E 16TH AVE
AURORA, CO 80045
Adams County (720) 777-1234

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 Carly Tiedke's NPI number?

The NPI number for Carly Tiedke is 1740807189. It was assigned to this individual provider in the NPPES registry on July 1, 2020.

Where is Carly Tiedke located?

Carly Tiedke practices at 13123 E 16th Ave, Aurora, CO 80045. The listed phone number is (720) 777-1234.

What is Carly Tiedke's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Carly Tiedke enrolled in Medicare?

Yes. Carly Tiedke is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Carly Tiedke accept?

Health plans from Medica and UnitedHealthcare list Carly Tiedke as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carly Tiedke was last updated on February 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.