Individual provider Active NPI

Samuel Chand Tyagi, M.D.

  • Vascular Surgery Physician
  • Lexington, KY
National Provider Identifier
1053638734
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
03534 Issued in NC
Practice address
800 Rose St # C212
Lexington, KY 40536-7001
Phone
(859) 323-6602
Fax
(859) 323-6840
NPI assigned
Apr 21, 2010
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Vascular Surgery Physician 2086S0129X 97267 SC
Vascular Surgery Physician 2086S0129X 03534 NC Primary
Vascular Surgery Physician 2086S0129X 50119 KY

Addresses

Primary practice location

800 Rose St # C212
Lexington, KY 40536-7001

Mailing address

1237 Harding PL
#4400
Charlotte, NC 28204
Phone (704) 373-0212

Other practice location 1

First Avenue at 16th Street
New York, NY 10003
Phone (212) 420-3842

Other practice location 2

1237 Harding Pl 4400
Charlotte, NC 28204
Phone (704) 373-0212

Other identifiers 3

IdentifierTypeStateIssuer
03534OtherNCLICENSURE
97267OtherSCLICENSURE
50119OtherKYLICENSURE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20170724002882 KY Practitioner - Vascular Surgery 4183994130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Louisville School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

740 S Limestone St
Lexington, KY 40508-1683
Phone (859) 257-8562

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
97267SCMDFamily Medicine Physician
50119KYMDVascular Surgery Physician
03534NCMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Medical Services Foundation, Inc CurrentSince Jul 14, 2017 Accepting new patients
St Claire Medical Center, Inc CurrentSince Jan 25, 2018 Accepting new patients
St Claire Medical Center, Inc., CurrentSince Jan 25, 2018 Accepting new patients
St Claire Medical Center, Inc., Current Accepting new patients
University of Kentucky Past Accepting new patients
University of Kentucky Past Accepting new patients

Locations

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

800 Rose St
#C212
Lexington, KY 40536
Phone (859) 323-6602

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6500

245 Flemingsburg Rd
Morehead, KY 40351
Phone (606) 780-5500

555 W Sun St
Morehead, KY 40351
Phone (606) 207-2931

Interoperability endpoints

  • Direct secure messaging: styagi18969@ukhcdirect.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1053638734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 HARDING PL",
            "address_2": "#4400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-373-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST # C212",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405367001",
            "telephone_number": "859-323-6602",
            "fax_number": "859-323-6840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "First Avenue at 16th Street",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10003",
            "country_code": "US",
            "telephone_number": "212-420-3842",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl 4400",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-373-0212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYAGI",
        "first_name": "SAMUEL",
        "middle_name": "CHAND",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-21",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "97267",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "03534",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "KY",
            "license": "50119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "03534",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "97267",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "50119",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.