Individual provider Active NPI

Tyler Koestner

  • Surgical Critical Care Physician
  • Lexington, KY
National Provider Identifier
1053739284
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
53846 Issued in KY
Practice address
800 Rose St
Lexington, KY 40536-2104
Phone
(859) 323-6013
NPI assigned
Apr 4, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgical Critical Care Physician 2086S0102X 53846 KY Primary

Addresses

Primary practice location

800 Rose St
Lexington, KY 40536-2104

Mailing address

911 Hillsboro Rd
Franklin, TN 37064-2015

Other practice location 1

960 E 3rd St
Suite 104
Chattanooga, TN 37403-2104
Phone (423) 778-7695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240612002064 VA Practitioner - General Surgery 8729401229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1213 E Clay St
Richmond, VA 23298-5071
Phone (804) 828-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Apr 2, 2024 Accepting new patients
Kentucky Medical Services Foundation, Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

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

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

9109 Stony Point Dr
Richmond, VA 23235
Phone (804) 827-8000

1001 E Leigh St
Richmond, VA 23298
Phone (804) 628-7497

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1213 E Clay St
Richmond, VA 23298
Phone (804) 827-1207

11958 W Broad St
Richmond, VA 23233
Phone (804) 360-4669

659 Hospital Rd
Ste 203
Tappahannock, VA 22560
Phone (804) 443-6232

Interoperability endpoints

  • Direct secure messaging: tkoestner33340@ukhcdirect.org

Organizations & group practices 2

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.

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": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1053739284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 HILLSBORO RD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370642015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405362104",
            "telephone_number": "859-323-6013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "960 E 3rd St",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374032104",
            "country_code": "US",
            "telephone_number": "423-778-7695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOESTNER",
        "first_name": "TYLER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-04",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "KY",
            "license": "53846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.