Tyler John Back, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

3366 Oakdale Ave N Ste 303
Robbinsdale, MN 55422-2977

Phone

(763) 520-7700

Fax

(763) 520-7776

NPI assigned

Sep 19, 2018

Last updated

Sep 19, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Minnesota Urology, PAGroup PAC ID 0840183984, 83 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
• Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214
• Ridgeview Medical Center Hospital, Waconia, MN, CCN 240056

Merit-based Incentive Payment System (MIPS)

Final score

84.84 of 100Reported as group

Quality

64.59

Promoting interoperability

100

Improvement activities

40

Cost

84.88

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: tyler.back.1@20581.direct.athenahealth.com

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.

• Minnesota Urology, PA

  dba Metro Urology

  • Urology Physician
  • Woodbury, MN
  • NPI 1912971912
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Maple Grove Hospital Corporation

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1225272552
  Care Compare affiliation
• North Memorial Health Care

  dba North Memorial Ambulance Service

  • Ambulance
  • Brooklyn Center, MN
  • NPI 1538195912

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  dba North Memorial Health Specialty Center - Robbinsdale

  • Medical Specialty Clinic/Center
  • Robbinsdale, MN
  • NPI 1699953000

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  dba North Memorial Health Hospital

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Waconia, MN
  • NPI 1275608457
  Care Compare affiliation
• Ridgeview Medical Center

  • General Acute Care Hospital
  • Chaska, MN
  • NPI 1710748538
  Care Compare affiliation

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1144704867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N STE 303",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222977",
            "telephone_number": "763-520-7700",
            "fax_number": "763-520-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 OAKDALE AVE N STE 303",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222977",
            "telephone_number": "763-520-7700",
            "fax_number": "763-520-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACK",
        "first_name": "TYLER",
        "middle_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Rae Aumock, PAC
• Katelyn Austin
• Laurie S. Azine, D.O.
• Kristin Babine-Dinnen, APRN, CNP
• Ben R Bache-Wiig, M.D.
• Trent Robert Bailey, M.D.
• Balanced Chiropractic LLC (Balanced Chiropractic)
• Margaret A Baranowski, PA-C
• Kayla J Barnard, PA-C
• Stephen W Barnhart, MD

• Physician Assistant in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.