DR. GRACE ELIZABETH TIDEMAN MD
NPI 1932840709
Student in an Organized Health Care Education/Training Program in Kansas City, KS

Q: What is Grace Tideman's NPI number?

The NPI number for Grace Tideman is 1932840709. It was assigned to this individual provider in the NPPES registry on April 5, 2022.

Q: What is Grace Tideman's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Grace Tideman was last updated on April 5, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 05, 2022PECOS Enrolled

3901 RAINBOW BLVD # MS 3017, KANSAS CITY, KS 66160(913) 588-0575(913) 535-2161 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Grace Elizabeth Tideman Md NPPES

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

DR. GRACE ELIZABETH TIDEMAN MD (NPI 1932840709) is an individual student in an organized health care education/training program in Kansas City, Kansas and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1932840709

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. GRACE ELIZABETH TIDEMANCredential: MD

Location Address3901 RAINBOW BLVD # MS 3017Kansas City, KS 66160-8500

Mailing Address3901 Rainbow Blvd # Ms 3017Kansas City, KS 66160-8500 · (913) 588-0575 · Fax (913) 535-2161

Phone(913) 588-0575

Fax(913) 535-2161

Sole ProprietorNo

Enumeration DateApril 5, 2022

NPPES CertifiedApril 5, 2022

✔ NPI 1932840709 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.

3901 RAINBOW BLVD # MS 3017, Kansas City, KS 66160

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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)

Dr. Grace Elizabeth Tideman Md 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.

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