Tyrell Lancelot Gardner, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

0101267751 Issued in VA

Practice address

500 J Clyde Morris Blvd
Newport News, VA 23601-1929

Phone

(757) 594-2000

NPI assigned

May 24, 2018

Last updated

Jul 30, 2024By 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

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

Specialty

Diagnostic Radiology

Education

Eastern Virginia Medical School, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peninsula Radiological Associates LimitedGroup PAC ID 5991603573, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
• Riverside Walter Reed Hospital Hospital, Gloucester, VA, CCN 490130
• Riverside Shore Memorial Hospital Hospital, Onancock, VA, CCN 490037
• Riverside Doctors' Hospital of Williamsburg Hospital, Williamsburg, VA, CCN 490143
• Riverside Smithfield Hospital Hospital, Smithfield, VA, CCN 490149

Merit-based Incentive Payment System (MIPS)

Final score

98.12 of 100Reported as group

Quality

97.78

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tgardner245230@direct.rivhs.com

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.

• Peninsula Radiological Associates Limited

  • Diagnostic Radiology Physician
  • Newport News, VA
  • NPI 1114030426

  Vascular & Interventional Radiology

  Medicare reassignment Care Compare group NPD

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

• Doctors' Hospital of Williamsburg

  dba Riverside Doctors Hospital Williamsburg

  • General Acute Care Hospital
  • Williamsburg, VA
  • NPI 1275893307
  Care Compare affiliation
• Riverside Hospital Inc

  dba Riverside Smithfield Hospital

  • General Acute Care Hospital
  • Smithfield, VA
  • NPI 1366259863
  Care Compare affiliation
• Riverside Hospital Inc

  dba Riverside Regional Medical Center

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1366547747
  Care Compare affiliation
• Riverside Middle Peninsula Hospital Inc

  dba Riverside Walter Reed Hospital

  • General Acute Care Hospital
  • Gloucester, VA
  • NPI 1528162534
  Care Compare affiliation
• Shore Health Services Inc.

  dba Riverside Shore Memorial Hospital

  • Rural Acute Care Hospital
  • Onancock, VA
  • NPI 1619076916
  Care Compare affiliation

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1083105050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-594-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-594-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "TYRELL",
        "middle_name": "LANCELOT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "VA",
            "license": "0101267751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Tereselna Gantan
• Suzanne Marie Garber, MSW
• Marycruz Garcia-Reyes, LAT, ATC
• Rebeca F Garcia
• Brandon Gardner
• Desaray Garland, LCSW-S
• Katherine Kaeppler Garling, DO
• Alexandria Lea Garlow, PA
• Carol Jean Garn, LPTA
• Wallace Kirby Garner, MD

• Vascular & Interventional Radiology Physician in Newport News, VA
• Providers in Newport News, VA by specialty
• Vascular & Interventional Radiology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.