Individual provider Active NPI

Tyler M Duncan, DO

  • Orthopaedic Surgery Physician
  • Bristol, TN
National Provider Identifier
1154737799
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
3618 Issued in TN
Practice address
340 Steeles Rd
Bristol, TN 37620
Phone
(423) 280-9011
Fax
(423) 282-0035
NPI assigned
Jul 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 3618 TN Primary

Addresses

Primary practice location

340 Steeles Rd
Bristol, TN 37620

Mailing address

2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011

Other practice location 1

875 Larry Neil Way
Kingsport, TN 37660-6368
Phone (423) 282-9011

Other practice location 2

2412 Susannah St
Johnson City, TN 37601-1726
Phone (423) 282-9011

Other practice location 3

2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011

Other identifiers 1

IdentifierTypeStateIssuer
3618OtherTNTN MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20190729000390 TN Practitioner - Orthopedic Surgery 5698001725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watauga Orthopaedics PLCGroup PAC ID 1456246479, 85 clinicians
Dominion Health and Fitness, IncGroup PAC ID 3274570908, 71 clinicians

Practice addresses (Care Compare)

2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011

4862 Dickenson Hwy
PO Box 1810
Clintwood, VA 24228-1810

Hospital & facility affiliations

  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Merit-based Incentive Payment System (MIPS)

Final score
79.46 of 100Reported as individual
Quality
65.39
Promoting interoperability
95
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement22
Knee replacement17
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3618TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Orthopaedics, PLC Orthopaedic Surgery CurrentSince Jul 15, 2019 Accepting new patients
Watauga Orthopaedics PLC Orthopaedic Surgery CurrentSince Jul 15, 2019 Accepting new patients

Locations

340 Steeles Rd
Bristol, TN 37620
Phone (423) 282-9011

2412 Susannah St
Johnson City, TN 37601
Phone (423) 282-8070

2410 Susannah St
Johnson City, TN 37601
Phone (423) 282-9011

875 Larry Neil Way
Kingsport, TN 37660
Phone (423) 282-9011

Interoperability endpoints

  • Direct secure messaging: tyler.duncan.1@3374.direct.athenahealth.com

Organizations & group practices 3

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 2

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": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1154737799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 STEELES RD",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-280-9011",
            "fax_number": "423-282-0035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Larry Neil Way",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376606368",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2412 Susannah St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376011726",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2410 Susannah St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376011748",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "fax_number": "423-282-0035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNCAN",
        "first_name": "TYLER",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-03",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "3618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN MEDICAL LICENSE",
            "identifier": "3618",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.