Individual provider Active NPI

Tyler D Dulworth, M.D.

  • Family Medicine Physician
  • Goldsby, OK
National Provider Identifier
1083237663
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38333 Issued in OK
Practice address
117 Cotton Field Rd Ste 101
Goldsby, OK 73093-5050
Phone
(405) 307-1000
NPI assigned
May 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38333 OK Primary

Addresses

Primary practice location

117 Cotton Field Rd Ste 101
Goldsby, OK 73093-5050

Mailing address

PO Box 1330
Norman, OK 73070-1330
Phone (405) 307-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20241011003984 OK Practitioner - Family Practice 2860924040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Norman Regional Providers Primary CareGroup PAC ID 5496837718, 56 clinicians

Practice addresses (Care Compare)

2605 SW 119TH St a
Primary Care
Oklahoma City, OK 73170-2601
Phone (405) 912-3400

2605 SW 119TH St B
Chiropractic and Wellness Clinic
Oklahoma City, OK 73170-2601
Phone (405) 912-3900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Norman Regional Providers Primary Care Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Norman Regional Hospital Authority Past Accepting new patients

Locations

117 Cotton Field Rd
Ste 101
Goldsby, OK 73093

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

2605 SW 119th St
Ste A
Oklahoma City, OK 73170
Phone (405) 912-3100

Interoperability endpoints

  • Direct secure messaging: tyler.dulworth@nrh.eclinicaldirectplus.com

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 6

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": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1083237663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1330",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730701330",
            "telephone_number": "405-307-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 COTTON FIELD RD STE 101",
            "city": "GOLDSBY",
            "state": "OK",
            "postal_code": "730935050",
            "telephone_number": "405-307-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULWORTH",
        "first_name": "TYLER",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "38333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsby, OK

Sources for this page

Verify at the official NPI Registry.