Individual provider Active NPI

Tyler Kenneth Sorensen, DPM

  • Foot & Ankle Surgery Podiatrist
  • Wisconsin Rapids, WI
National Provider Identifier
1104310929
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO4400 Issued in WI
Practice address
140 24TH St S
Wisconsin Rapids, WI 54494-1906
Phone
(715) 424-1881
NPI assigned
Jun 15, 2018
Last updated
Oct 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO4400 WI Primary

Addresses

Primary practice location

140 24TH St S
Wisconsin Rapids, WI 54494-1906

Mailing address

140 24TH St S
Wisconsin Rapids, WI 54494-1906
Phone (715) 424-1881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210719000636 WI Practitioner - Podiatry 5991107666 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
College of Podiatric Med and Surgery, Des Moines University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wisconsin River Orthopaedics, LTD.Group PAC ID 4880607431, 18 clinicians

Practice addresses (Care Compare)

140 24TH St S
Wisconsin Rapids, WI 54494-1906
Phone (715) 424-1881

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO4400WIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Wisconsin River Orthopaedics, LTD. CurrentSince Sep 11, 2023 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Oct 1, 2023 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

140 24th St S
Wisconsin Rapids, WI 54494
Phone (715) 424-1881

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1104310929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 24TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544941906",
            "telephone_number": "715-424-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 24TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544941906",
            "telephone_number": "715-424-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "TYLER",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "PO4400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

Verify at the official NPI Registry.