Keely Tietjen, PA-C
NPI 1639738040 · Physician Assistant · Alameda, CA
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Keely Tietjen, PA-C is a Physician Assistant provider in Alameda, CA (NPI 1639738040).
Provider details
- NPI number
- 1639738040
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- PA56700 (CA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-06-10
- Last updated
- 2022-01-03
Frequently asked questions
- What is Keely Tietjen's NPI number?
- Keely Tietjen's National Provider Identifier (NPI) is 1639738040, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Keely Tietjen's specialty?
- Keely Tietjen is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Keely Tietjen located?
- Keely Tietjen's practice location on file with NPPES is 2070 Clinton Ave, Alameda, CA 94501-4399.
- What is Keely Tietjen's phone number?
- The practice phone number listed in the NPPES registry for Keely Tietjen is (510) 864-1800.
- Does Keely Tietjen accept Medicare?
- Keely Tietjen is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Keely Tietjen's NPI active?
- Yes — Keely Tietjen's NPI (1639738040) is active in the NPPES registry as of the last update on 2022-01-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.