Individual provider Active NPI

Tyler M Lewark, M.D.

  • Otolaryngology Physician
  • Aurora, CO
National Provider Identifier
1073620993
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
36897 Issued in CO
Practice address
1400 S Potomac St
Suite 240
Aurora, CO 80012-4528
Phone
(303) 750-8600
Fax
(303) 743-7800
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 36897 CO Primary

Addresses

Primary practice location

1400 S Potomac St
Suite 240
Aurora, CO 80012-4528

Mailing address

4900 S Monaco St
Suite 210
Denver, CO 80237-3486
Phone (303) 750-8600

Other practice location 1

8101 E Lowry Blvd Ste 210
Denver, CO 80230-7195
Phone (720) 321-3550

Other identifiers 3

IdentifierTypeStateIssuer
08580821MedicaidCO
1073620993MedicaidWY
12105864MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TYLER.LEWARK@hca3.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20100505000162 CO Practitioner - Otolaryngology 6406743616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

10470 S Progress Way
Unit 104
Parker, CO 80134-4037
Phone (303) 617-4700

8101 E Lowry Blvd
Denver, CO 80230-7195
Phone (720) 321-3550

Hospital & facility affiliations

  • Centura Health-St Anthony Hospital Hospital, Lakewood, CO, CCN 060015

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36897COMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Otolaryngology CurrentSince Jan 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

8101 E Lowry Blvd
Ste 210
Denver, CO 80230
Phone (303) 831-7419

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Interoperability endpoints

  • Direct secure messaging: tyler.lewark@hca3.eclinicaldirectplus.com

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.

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1073620993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S MONACO ST",
            "address_2": "SUITE 210",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802373486",
            "telephone_number": "303-750-8600",
            "fax_number": "303-743-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S POTOMAC ST",
            "address_2": "SUITE 240",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124528",
            "telephone_number": "303-750-8600",
            "fax_number": "303-743-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8101 E Lowry Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802307195",
            "country_code": "US",
            "telephone_number": "720-321-3550",
            "fax_number": "720-321-3551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWARK",
        "first_name": "TYLER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "36897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08580821",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073620993",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12105864",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TYLER.LEWARK@hca3.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1400 S Potomac St",
            "address_2": "SUITE 240",
            "city": "Aurora",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800124528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.