Individual provider Active NPI

Tyler Looysen, MD, MPH

  • Retina Specialist (Ophthalmology) Physician
  • Fargo, ND
National Provider Identifier
1134614381
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
License
21234 Issued in ND
Practice address
4450 31St Ave S Ste 200
Fargo, ND 58104-4598
Phone
(701) 293-9829
Fax
(701) 293-0111
NPI assigned
Jun 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 21234 ND
Retina Specialist (Ophthalmology) Physician 207WX0107X 21234 ND Primary

Addresses

Primary practice location

4450 31St Ave S Ste 200
Fargo, ND 58104-4598

Mailing address

4450 31St Ave S Ste 200
Fargo, ND 58104-4598
Phone (701) 293-9829

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tlooysen@rcfargo.intellechartdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, ND2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220725002258 MN Practitioner - Ophthalmology 2860734449 Reassigns benefits to 1 organization
I20240731003072 ND Practitioner - Ophthalmology 2860734449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of North Dakota School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Consultants, LTDGroup PAC ID 7618936568, 5 clinicians

Practice addresses (Care Compare)

4450 31St Ave S
Suite 200
Fargo, ND 58104-4556
Phone (701) 293-9829

Hospital & facility affiliations

  • Essentia Health Hospital, Fargo, ND, CCN 350070
  • M Health Fairview University of MN Medical Center Hospital, Minneapolis, MN, CCN 240080
  • Sanford Medical Center Fargo Hospital, Fargo, ND, CCN 350011

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.66 of 100Reported as group
Quality
79.17
Promoting interoperability
100
Improvement activities
40
Cost
73.43

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
67.02
Promoting interoperability
99
Improvement activities
40
Cost
73.13

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21234NDMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jul 11, 2022 Accepting new patients
Fairview Express Care CurrentSince Jul 11, 2022 Accepting new patients
Retina Consultants, LTD Ophthalmology CurrentSince Aug 12, 2024 Accepting new patients

Locations

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

516 Delaware St SE
Ste 9100
Minneapolis, MN 55455

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

4450 31st Ave S
Ste 200
Fargo, ND 58104
Phone (701) 293-9829

Interoperability endpoints

  • Direct secure messaging: tlooysen@rcfargo.intellechartdirect.net

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 9

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1134614381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 200",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044598",
            "telephone_number": "701-293-9829",
            "fax_number": "701-293-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 31ST AVE S STE 200",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581044598",
            "telephone_number": "701-293-9829",
            "fax_number": "701-293-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOYSEN",
        "first_name": "TYLER",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "ND",
            "license": "21234",
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "ND",
            "license": "21234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlooysen@rcfargo.intellechartdirect.net",
            "affiliation": "N",
            "endpointDescription": "Send/receive CCDA only",
            "address_1": "4450 31st Ave S Ste 200",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581044598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.