Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blake Tiedtke, DPT

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1922248566

Blake Tiedtke, DPT is a Physical Therapist in Private Practice in Cedar Rapids, Iowa. Qualified in 2008, 18 years ago. Practices with Match Play Tennis Centers Inc, a 13-clinician group and accepts Medicare assignment. Licensed in Iowa.

Years since qualifying
18
Licensed in
IA
In the registry since
2009
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

See every abbreviation used in this directory →

Practice location Address checks out

645 32nd Ave SW Ste A
Cedar Rapids, IA 52404-3907
Phone: (319) 363-2901
Fax: (319) 363-2903
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 004341 (IA)

Record details

NPI number1922248566
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedFebruary 23, 2009
Last updated in NPPESMarch 4, 2020
Certification dateMarch 4, 2020
Mailing address3290 Ridgeway Dr, Ste 3, Coralville, IA 52241

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Match Play Tennis Centers Inc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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