NPIMap

Individual provider Active NPI

Tyler Kunz, DO

  • Family Medicine Physician
  • Pocatello, ID
National Provider Identifier
1114656428
Registry record updated Jun 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MRO-2170 Issued in ID
Practice address
465 Memorial Dr
Pocatello, ID 83201-4008
Phone
(208) 232-7862
NPI assigned
Jun 10, 2022
Last updated
Jun 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2022

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 MRO-2170 ID Primary

Addresses

Primary practice location

465 Memorial Dr
Pocatello, ID 83201-4008

Mailing address

500 S 11TH Ave Ste 400
Pocatello, ID 83201-4880
Phone (208) 232-7862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20250724001057 ID Practitioner - Family Practice 5092159178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rocky Vista University College of Osteopathic Med, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health West IncGroup PAC ID 4981500931, 67 clinicians

Practice addresses (Care Compare)

465 Memorial Dr
Pocatello, ID 83201-4008
Phone 20823278621122

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MRO-2170IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health West, Inc. Current Accepting new patients
Health West, Inc. Family Medicine Current Accepting new patients
Health West Inc. CurrentSince Jul 9, 2025 Accepting new patients
Oneida County Hospital CurrentSince Jan 1, 2026 Accepting new patients
Health West, Inc. Family Medicine Current Accepting new patients
Oneida County Hospital CurrentSince Jan 1, 2026 Accepting new patients
Health West, Inc. Family Medicine Current Accepting new patients
Health West, Inc. CurrentSince Jul 9, 2025 Accepting new patients
Health West, Inc. Past Accepting new patients

Locations

823 Reed St
American Falls, ID 83211
Phone (208) 226-2822

150 N 200 W
Malad City, ID 83252
Phone (208) 766-2231

1000 N 8th Ave
Pocatello, ID 83201
Phone (208) 232-3368

1001 N 7th Ave
Ste 135
Pocatello, ID 83201
Phone (208) 234-2489

465 Memorial Dr
Pocatello, ID 83201
Phone (208) 234-4700

500 S 11th Ave
Ste 400
Pocatello, ID 83201

Interoperability endpoints

  • Direct secure messaging: tkunz469445@ahs.direct-ci.com
  • Direct secure messaging: tyler.kunz.1@13153.direct.athenahealth.com
  • Direct secure messaging: tyler.kunz.1@16258.direct.athenahealth.com

Organizations & group practices 9

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": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1114656428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE STE 400",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014880",
            "telephone_number": "208-232-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014008",
            "telephone_number": "208-232-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNZ",
        "first_name": "TYLER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MRO-2170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.