Tyler Scott Mittelstaedt, MD-MPH

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD183147 Issued in OR

Practice address

1510 Division St Ste 210
Oregon City, OR 97045-1599

Phone

(503) 723-6525

NPI assigned

Apr 12, 2012

Last updated

Jun 9, 2023By the provider in NPPES

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 OR, WA2 enrollments

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 2

Specialty

General Surgery

Education

Oregon Health Sciences University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Public Hospital District No. 2, Klickitat County, WashingtonGroup PAC ID 4981592144, shared by 4 NPIs, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Skyline Hospital Hospital, White Salmon, WA, CCN 501315
• Providence Hood River Memorial Hospital Hospital, Hood River, OR, CCN 381318

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/
• Direct secure messaging: tmittelstaedt138213@oc.providencedirect.org

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.

• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment NPD
• Providence Health & Services Oregon

  dba Providence Milwaukie Hospital

  • General Acute Care Hospital
  • Milwaukie, OR
  • NPI 1366536963
  Medicare reassignment NPD
• Public Hospital District No 2, Klickitat County Washington

  dba Skyline Hospital

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1952483653
  Medicare reassignment NPD
• Public Hospital District No. 2, Klickitat County, Washington

  dba Skyline Hospital

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1760455687
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Hematology & Oncology Physician
  • Portland, OR
  • NPI 1760726293
  NPD
• Providence Health & Services Oregon

  dba Providence Milwaukie Hospital

  • Clinical Pathology Physician
  • Milwaukie, OR
  • NPI 1578014239
  NPD
• Providence Health & Services Oregon

  • Psychiatric Hospital Unit
  • Milwaukie, OR
  • NPI 1659751360
  NPD
• Providence Health & Services Oregon

  dba Providence Medical Group

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Public Hospital District No 2, Klickitat County, Washington

  dba Skyline Medical Clinic

  • Rural Health Clinic/Center
  • White Salmon, WA
  • NPI 1467961250
  NPD
• Oregon Cosmetic and Reconstructive Clinic, PC

  • Plastic Surgery Physician
  • Milwaukie, OR
  • NPI 1407177934
  NPD (past)

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

• Providence Health & Services Oregon

  dba Providence Hood River Memorial Hospital

  • Critical Access Hospital
  • Hood River, OR
  • NPI 1255429338
  Care Compare affiliation
• Public Hospital District No. 2, Klickitat County, Washington

  dba Skyline Hospital

  • Critical Access Hospital
  • White Salmon, WA
  • NPI 1760455687
  Care Compare affiliation

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1053678284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 DIVISION ST STE 210",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451599",
            "telephone_number": "503-723-6525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 SE 91st Ave Ste 320",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "970863756",
            "country_code": "US",
            "telephone_number": "503-353-3005",
            "fax_number": "503-546-3201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITTELSTAEDT",
        "first_name": "TYLER",
        "middle_name": "SCOTT",
        "credential": "MD-MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD183147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmittelstaedt138213@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1510 Division St Ste 210",
            "city": "Oregon City",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970451599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Roxanne Lee Miller, MSW
• Ames Milligan, OTR/L
• Gayle Miner
• Heather Mirenda
• Kelli N Mitchell, NCC
• Paul Modesitt, CADC1
• Nanea Ikeahonuiokamaile Moke-Rabang
• Tessa J Molter, PAC
• Linda M Monk, LMFT
• Dana R Moody, RDH, BS

• Surgery Physician in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Surgery Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.