NPIMap

Individual provider Active NPI

Tyler Scott Noble, D.O.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Conway, SC
National Provider Identifier
1093004350
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X
License
39926 Issued in SC
Practice address
2376 Cypress Cir Ste 300
Conway, SC 29526-8995
Phone
(843) 353-3460
Fax
(843) 353-3461
NPI assigned
Apr 6, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X OS13810 FL
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X 39926 SC Primary
Orthopaedic Surgery Physician 207X00000X OT014290 PA

Addresses

Primary practice location

2376 Cypress Cir Ste 300
Conway, SC 29526-8995

Mailing address

210 Village Center Blvd Ste 140
Myrtle Beach, SC 29579-6706
Phone (843) 353-3460

Other identifiers 4

IdentifierTypeStateIssuer
017374400MedicaidFL
OT014290OtherPALICENSE NO
S4WBPOtherFLBCBS
399269MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170619000189 SC Practitioner - Orthopedic Surgery 4284856634 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthosc LLCGroup PAC ID 8022370030, 113 clinicians

Practice addresses (Care Compare)

2376 Cypress Cir
Suite 300
Conway, SC 29526-8995
Phone (843) 353-3460

Hospital & facility affiliations

  • Amedisys Home Health of Conway Home health agency, Conway, SC, CCN 427112
  • Centerwell Home Health Home health agency, Myrtle Beach, SC, CCN 427045
  • Well Care Home Health of the Lowcountry Inc Home health agency, Myrtle Beach, SC, CCN 427138
  • Conway Medical Center Hospital, Conway, SC, CCN 420049
  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105
  • Tidelands Waccamaw Community Hospital Hospital, Murrells Inlet, SC, CCN 420098

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement104
Knee replacement115
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OT014290PAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosc, LLC Orthopaedic Surgery CurrentSince Apr 1, 2018 Accepting new patients
Orthosc, LLC Orthopaedic Surgery CurrentSince Apr 1, 2018 Accepting new patients
Orthosc, LLC Orthopaedic Surgery PastSince May 29, 2022 Accepting new patients

Locations

2376 Cypress Cir
Ste 300
Conway, SC 29526
Phone (843) 347-7222

210 Village Center Blvd
Ste 140
Myrtle Beach, SC 29579
Phone (843) 333-8385

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tyler.noble.1@17161.direct.athenahealth.com

Organizations & group practices 3

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1302048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1093004350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 VILLAGE CENTER BLVD STE 140",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295796706",
            "telephone_number": "843-353-3460",
            "fax_number": "843-353-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 CYPRESS CIR STE 300",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268995",
            "telephone_number": "843-353-3460",
            "fax_number": "843-353-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "TYLER",
        "middle_name": "SCOTT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-06",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "OS13810",
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "SC",
            "license": "39926",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OT014290",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017374400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NO",
            "identifier": "OT014290",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "S4WBP",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "399269",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.