Active NPI
Tyler Justin Paradis, MD
- Anesthesiology Physician
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD60821188
- Practice address
- 400 NE Mother Joseph PL
Vancouver, WA 98664 - Phone
- (360) 828-5396
- Fax
- (360) 828-5455
- NPI assigned
- Mar 28, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD60821188 | WA | Primary |
| Anesthesiology Physician | 207L00000X | MD175844 | OR |
Addresses
Primary practice location
400 NE Mother Joseph PL
Vancouver, WA 98664
Mailing address
505 NE 87TH Ave Ste 210
Vancouver, WA 98664-1988
Phone (360) 828-5396
Other practice location 1
2211 NE 139th St
Vancouver, WA 98686-2742
Phone (360) 828-5396
Other practice location 2
1615 Delaware St
Longview, WA 98632-2367
Phone (360) 414-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1015 NW 22ND Ave
Portland, OR 97210-3025
Phone (360) 828-5396
2211 NE 139TH St
Vancouver, WA 98686-2742
Phone (360) 487-1000
400 NE Mother Joseph Place
Vancouver, WA 98664-3200
Phone (360) 256-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oregon Anesthesiology Group PC | Anesthesiology | Current | Accepting new patients |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| Columbia Anesthesia Group P S | Anesthesiology | Current | Accepting new patients |
| University Professional Services | Current | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582
3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674
7300 SW Childs Rd
Ste A
Tigard, OR 97224
Phone (360) 828-5396
1615 Delaware St
Longview, WA 98632
Phone (360) 363-4818
400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000
505 NE 87th Ave
Ste 210
Vancouver, WA 98664
Phone (360) 828-5396
2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Portland, OR
- NPI 1376709535
-
dba OHSU Home Infusion Pharmacy
- Pharmacy
- Beaverton, OR
- NPI 1073054714
-
dba OHSU Intercultural Psychiatric Program
- Adult Mental Health Clinic/Center
- Portland, OR
- NPI 1750753687
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Legacy Salmon Creek Providers
- Clinic/Center
- Vancouver, WA
- NPI 1356357784
Hospital
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
-
dba PeaceHealth SW Heart & Vascular Center
- Cardiovascular Disease Physician
- Vancouver, WA
- NPI 1003194911
Hospital
-
dba PeaceHealth Southwest Medical Center
- General Acute Care Hospital
- Vancouver, WA
- NPI 1134178999
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1003159096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 NE 87TH AVE STE 210",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986641988",
"telephone_number": "360-828-5396",
"fax_number": "360-828-5455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 NE MOTHER JOSEPH PL",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98664",
"telephone_number": "360-828-5396",
"fax_number": "360-828-5455"
}
],
"practiceLocations": [
{
"address_1": "2211 NE 139th St",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986862742",
"country_code": "US",
"telephone_number": "360-828-5396",
"fax_number": "360-828-5455",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1615 Delaware St",
"address_purpose": "LOCATION",
"city": "Longview",
"state": "WA",
"postal_code": "986322367",
"country_code": "US",
"telephone_number": "360-414-2000",
"fax_number": "360-414-7638",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PARADIS",
"first_name": "TYLER",
"middle_name": "JUSTIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-28",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WA",
"license": "MD60821188",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "OR",
"license": "MD175844",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
- Paprocki-Sims. LLC (Columbia Treatment Services)
- Jade Paquette
- Simon B. Paquette, LCSW
- Jean Michael Paradis, M.D.
- Patti L Paradis
- Paradox Northwest Associates, Inc (Homewatch Caregivers, Vancouver)
- Paradox Northwest Associates, Inc (Homewatch Caregivers of Southwest Washington)
- Paradox Northwest Associates, Inc. (Homewatch CareGivers of Vancouver)
- Paragon Hemophilia Solutions LLC (Paragon Infusion)
- Anjali Parajuli, MBBS, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.