Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Micah Ryan Tiegs, PA-C

Individual provider Physician Assistant · NPI 1538590757

Mr. Micah Ryan Tiegs, PA-C is a Physician Assistant in Rockford, Illinois. Qualified in 2013, 13 years ago. Practices with Crusaders Central Clinic Association, a 33-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
13
Licensed in
IL
In the registry since
2013
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1200 W State St
Rockford, IL 61102-2112
Phone: (815) 490-1600
Fax: (815) 490-1625
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.004941 (IL)

Record details

NPI number1538590757
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 13, 2013
Last updated in NPPESMarch 19, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Crusaders Central Clinic Association — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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