Individual provider Active NPI

Tyler K Stevens, M.D.

  • Gastroenterology Physician
  • University Heights, OH
National Provider Identifier
1114904729
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
81031 Issued in OH
Practice address
4095 Meadowbrook Blvd
University Heights, OH 44118-3854
Phone
(216) 371-4171
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-081031 OH
Gastroenterology Physician 207RG0100X 81031 OH Primary

Addresses

Primary practice location

4095 Meadowbrook Blvd
University Heights, OH 44118-3854

Mailing address

9500 Euclid Ave # A31
Cleveland, OH 44195-0001
Phone (216) 445-1996

Other identifiers 2

IdentifierTypeStateIssuer
2355768MedicaidOH
000000332717OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20050127000786 OH Practitioner - GastroenterologyPractitioner - Internal Medicine 2961452800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8530

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Fairview Hospital Hospital, Cleveland, OH, CCN 360077
  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364
  • Akron General Medical Center Hospital, Akron, OH, CCN 360027

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy32
Upper gastrointestinal (GI) endoscopy for acid reflux330

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-081031OHMDInternal Medicine Physician
81031OHMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jun 13, 2005 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
North East Ohio Group Practice LLC Internal Medicine Past Accepting new patients

Locations

9500 Euclid Ave
#A31
Cleveland, OH 44195
Phone (216) 444-2000

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

6780 Mayfield Rd
Mayfield Hts, OH 44124
Phone (440) 331-9520

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

Interoperability endpoints

  • Direct secure messaging: tstevens52978@direct.ccf.org

Organizations & group practices 4

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 5

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1114904729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # A31",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-445-1996",
            "fax_number": "216-444-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4095 MEADOWBROOK BLVD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441183854",
            "telephone_number": "216-371-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "TYLER",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-081031",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OH",
            "license": "81031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2355768",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000332717",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in University Heights, OH

Sources for this page

Verify at the official NPI Registry.