Tyler Bernard Shubitowski, MD

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

01096739A Issued in IN

Practice address

1030 W Michigan St Ste C4600
Indianapolis, IN 46202-5201

Phone

(317) 274-4716

NPI assigned

Apr 3, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1617408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1104405612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 W MICHIGAN ST STE C4600",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 W MICHIGAN ST STE C4600",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025201",
            "telephone_number": "317-274-4716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8001 Challis Rd",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MI",
            "postal_code": "481167446",
            "country_code": "US",
            "telephone_number": "734-539-5080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHUBITOWSKI",
        "first_name": "TYLER",
        "middle_name": "BERNARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-03",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301514707",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351049056",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01096739A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Shrift, MD
• Andrew Richard Shriner, M.D.
• Kirsten R Shriver, LMHC
• Mandy Lynn Shrock, COTA
• Paul P Shu, MD
• Caitlyn Carolyn Shuck, NP
• Elizabeth S Shuck, CANP, MSN
• Shudu LLC
• Micah J Shuey, LMHC
• Charles M Shufflebarger, M.D.

• Neonatal-Perinatal Medicine Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Neonatal-Perinatal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.