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

Mitchell Tiedke, PA

Individual provider Surgical Physician Assistant · NPI 1033719745

Mitchell Tiedke, PA is a Physician Assistant in Englewood, Colorado. Qualified in 2020, 6 years ago. Practices with University Physicians Incorporated, a 3,148-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
6
Licensed in
CO
In the registry since
2020
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3501 S Clarkson St
Englewood, CO 80113-3916
Phone: (763) 381-7160
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 13123 E 16th Ave, Aurora, CO 80045-7106 — (720) 777-1234

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA.0006543 (CO)

Record details

NPI number1033719745
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 30, 2020
Last updated in NPPESFebruary 16, 2023
Certification dateFebruary 16, 2023
Mailing addressPo Box 110429, Aurora, CO 80042-0429

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice University Physicians Incorporated — 3148 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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