NPIMap

Individual provider Active NPI

Tyler J. Kelly, DPM

  • Foot & Ankle Surgery Podiatrist
  • Evansville, IN
National Provider Identifier
1023458478
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
41000290A Issued in IN
Practice address
225 Crosslake Dr
Evansville, IN 47715-8198
Phone
(812) 477-1558
NPI assigned
Jun 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 41000290A IN Primary

Addresses

Primary practice location

225 Crosslake Dr
Evansville, IN 47715-8198

Mailing address

225 Crosslake Dr.
Evansville, IN 47715-7607
Phone (812) 477-1558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160512000535 IN Practitioner - Podiatry 0244529311 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-State Orthopaedic Surgeons Inc 60 clinicians
Orthopaedics-Indianapolis Inc 357 clinicians

Practice addresses (Care Compare)

225 Crosslake Dr
Evansville, IN 47715-8198
Phone (812) 477-1558

Hospital & facility affiliations

  • Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100
  • Gibson General Hospital Hospital, Princeton, IN, CCN 151319
  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082

Merit-based Incentive Payment System (MIPS)

Final score
66.6 of 100Reported as group
Quality
60.71
Promoting interoperability
33
Improvement activities
40
Cost
83.78

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41000290AINMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Orthopaedic Surgeons, Inc. Foot & Ankle Surgery CurrentSince Jun 1, 2017 Accepting new patients
Orthopaedics-Indianapolis, Inc CurrentSince Jul 1, 2025 Accepting new patients
Orthopaedics-Indianapolis, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Orthopaedics-Indianapolis, Inc Current Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. CurrentSince Jun 1, 2017 Accepting new patients

Locations

225 Crosslake Dr
Evansville, IN 47715
Phone (812) 471-6677

5625 Pearl Dr
Ste 101
Evansville, IN 47712
Phone (812) 474-3800

8450 Northwest Blvd
Indianapolis, IN 46278

Interoperability endpoints

  • Direct secure messaging: tyler.kelly.1@7598.direct.athenahealth.com
  • Direct secure messaging: 07kelt@tsos.srs-direct.com

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1023458478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 CROSSLAKE DR.",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477157607",
            "telephone_number": "812-477-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 CROSSLAKE DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477158198",
            "telephone_number": "812-477-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TYLER",
        "middle_name": "J.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-30",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "41000290A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.