Individual provider Active NPI

Tyler Mark Frizzi, DC

  • Chiropractor
  • Lafayette, IN
National Provider Identifier
1053901892
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003215A Issued in IN
Practice address
1716 Hartford St
Lafayette, IN 47904-2138
Phone
(765) 742-1567
Fax
(765) 742-2750
NPI assigned
Jan 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003215A IN Primary

Addresses

Primary practice location

1716 Hartford St
Lafayette, IN 47904-2138

Mailing address

1716 Hartford St
Lafayette, IN 47904-2138
Phone (765) 742-1567

Other practice location 1

416 W Camp St
Lebanon, IN 46052-1799
Phone (765) 483-4469

Other practice location 2

2121 S Gopher Dr BLDG
Frankfort, IN 46041-6800
Phone (765) 650-7875

Other practice location 3

2316 South St
Lafayette, IN 47904-2971
Phone (765) 742-1567

Other identifiers 1

IdentifierTypeStateIssuer
300050254MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210513001143 IN Practitioner - Chiropractic 6002225588 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08003215AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Boone County Community Health Clinic, Inc PastSince Sep 2, 2014 Accepting new patients
Riggs Community Health Center Inc Past Accepting new patients
Horizon Chiropractic LLC PastSince Jan 1, 2021 Accepting new patients

Organizations & group practices 4

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.

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riggs Community Health Center Inc 23 clinicians

Practice addresses (Care Compare)

1324 Tippecanoe St
Lafayette, IN 47904-2051
Phone (765) 742-1567

1716 Hartford St
Lafayette, IN 47904-2168

1716 Hartford St
Lafayette, IN 47904-2173
Phone 76574215673041

2316 S St
Lafayette, IN 47904-2971
Phone (765) 742-1567

NPI Registry JSON

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1053901892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042138",
            "telephone_number": "765-742-1567",
            "fax_number": "765-742-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 HARTFORD ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042138",
            "telephone_number": "765-742-1567",
            "fax_number": "765-742-2750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "416 W Camp St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "IN",
            "postal_code": "460521799",
            "country_code": "US",
            "telephone_number": "765-483-4469",
            "fax_number": "765-483-4495",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2121 S Gopher Dr BLDG",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "IN",
            "postal_code": "460416800",
            "country_code": "US",
            "telephone_number": "765-650-7875",
            "fax_number": "765-650-7803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2316 South St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479042971",
            "country_code": "US",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIZZI",
        "first_name": "TYLER",
        "middle_name": "MARK",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-26",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003215A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300050254",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.