Individual provider Active NPI

Adam James Tyler, APRN

  • Nurse Practitioner
  • Elkhart, IN
National Provider Identifier
1174298764
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71012584A Issued in IN
Practice address
1753 Fulton St
Elkhart, IN 46514-1927
Phone
(574) 293-9448
Fax
(574) 293-9480
NPI assigned
Aug 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28220091A IN
Nurse Practitioner 363L00000X 71012584A IN Primary
Family Nurse Practitioner 363LF0000X 2021085859 IN

Addresses

Primary practice location

1753 Fulton St
Elkhart, IN 46514-1927

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380
Phone (574) 647-6592

Other practice location 1

53760 Generations Dr
South Bend, IN 46635-1539
Phone (574) 500-2010

Other practice location 2

2606 Peddlers Village Rd Ste 215
Goshen, IN 46526-1004
Phone (888) 938-3838

Other practice location 3

5838 W Brick Rd Ste 106
South Bend, IN 46628-8420
Phone (574) 247-1911

Other identifiers 1

IdentifierTypeStateIssuer
300064075MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20220614001418 IN Practitioner - Nurse Practitioner 9739568288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group IncGroup PAC ID 1254243306, 575 clinicians
Vpa PCGroup PAC ID 9234041948, shared by 21 NPIs, 181 clinicians

Practice addresses (Care Compare)

1753 Fulton St
Elkhart, IN 46514-1927
Phone (574) 293-9448

5838 W Brick Rd
Suite 106
South Bend, IN 46628-8420
Phone (216) 678-4599

Hospital & facility affiliations

  • Elkhart General Hospital Hospital, Elkhart, IN, CCN 150018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28220091AINMDRegistered Nurse
71012584AINMDNurse Practitioner
2021085859INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. CurrentSince Dec 29, 2025 Accepting new patients
Beacon Medical Group Inc CurrentSince Dec 29, 2025 Accepting new patients

Locations

1753 Fulton St
Elkhart, IN 46514
Phone (574) 293-9448

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

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 1

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1174298764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "telephone_number": "574-647-6592",
            "fax_number": "574-647-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 FULTON ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141927",
            "telephone_number": "574-293-9448",
            "fax_number": "574-293-9480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "53760 Generations Dr",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466351539",
            "country_code": "US",
            "telephone_number": "574-500-2010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2606 Peddlers Village Rd Ste 215",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465261004",
            "country_code": "US",
            "telephone_number": "888-938-3838",
            "fax_number": "888-919-1083",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5838 W Brick Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466288420",
            "country_code": "US",
            "telephone_number": "574-247-1911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYLER",
        "first_name": "ADAM",
        "middle_name": "JAMES",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-16",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28220091A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71012584A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "2021085859",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300064075",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.