Tyler Brooks Fredenburg, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

01063947A Issued in IN

Practice address

1100 Reid Pkwy
Richmond, IN 47374-1157

Phone

(765) 983-3164

Fax

(765) 983-3260

NPI assigned

Jun 27, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

Indiana University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reid Health Hospital, Richmond, IN, CCN 150048
• Wayne Hospital Hospital, Greenville, OH, CCN 361335
• Ascension St Vincent Randolph Hospital, Winchester, IN, CCN 151301

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tfredenburg307552@ecommunitydirect.com
• Direct secure messaging: tfredenburg307552@reidhealth.direct-ci.com

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.

• Reid Physician Associates, Inc.

  • Internal Medicine Physician
  • Richmond, IN
  • NPI 1265689111
  Medicare reassignment Care Compare group NPD
• Imaging Associates of Indiana, PC

  • Diagnostic Radiology Physician
  • Indianapolis, IN
  • NPI 1699072611
  Medicare reassignment
• Reid Physician Associates, Inc

  • Radiology Clinic/Center
  • Winchester, IN
  • NPI 1417653221
  NPD
• Reid Physician Associates, Inc

  • Radiology Clinic/Center
  • Brookville, IN
  • NPI 1669171195
  NPD
• Reid Hospital & Health Care Services Inc

  • Internal Medicine Physician
  • Richmond, IN
  • NPI 1982633236

  Family Medicine

  NPD (past)
• Rush Memorial Hospital

  • Rural Health Clinic/Center
  • Rushville, IN
  • NPI 1659935781
  NPD (past)

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

• Reid Hospital & Health Care Services, Inc

  • General Acute Care Hospital
  • Richmond, IN
  • NPI 1063457380
  Care Compare affiliation
• St. Vincent Randolph Hospital, Inc.

  • Critical Access Hospital
  • Winchester, IN
  • NPI 1609826783
  Care Compare affiliation
• Wayne Hospital Company

  • Critical Access Hospital
  • Greenville, OH
  • NPI 1184621161
  Care Compare affiliation

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1033371406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "address_2": "ROOM 0641",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-278-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-983-3164",
            "fax_number": "765-983-3260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 University Blvd",
            "address_2": "Room 0641",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-278-2449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDENBURG",
        "first_name": "TYLER",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01063947A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfredenburg307552@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "REID HOSPITAL & HEALTH CARE SERVICES, INC",
            "address_1": "1100 Reid Pkwy",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Diagnostic Radiology Physician in Richmond, IN
• Providers in Richmond, IN by specialty
• Diagnostic Radiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.

Verify at the official NPI Registry.