Individual provider Active NPI

Tyler Brendan Draeger, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Warwick, RI
National Provider Identifier
1184074098
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
292835 Issued in MA
Practice address
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone
(401) 736-1092
Fax
(401) 738-0013
NPI assigned
Jun 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 292835 MA Primary
Surgery Physician 208600000X A160740 CA
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD19384 RI

Addresses

Primary practice location

455 Toll Gate Rd
Warwick, RI 02886-2759

Mailing address

75 Francis St
Division of Thoracic Surgery
Boston, MA 02115-6106
Phone (617) 525-6757

Other practice location 1

75 Francis St
Division of Thoracic Surgery
Boston, MA 02115-6106
Phone (617) 525-6757

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tdraeger@direct.carene.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, PA2 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
I20230922001001 MA Practitioner - Thoracic SurgeryPractitioner - General Surgery 5092065771 Reassigns benefits to 1 organization
I20240613000588 PA Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 5092065771 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A160740CAMDSurgery Physician
292835MAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD19384RIMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians CurrentSince Jul 1, 2024 Accepting new patients
University of Pittsburgh Physicians CurrentSince Jul 1, 2024 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Brigham & Womens Physicians Organization Inc CurrentSince Aug 9, 2023 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

62 13th St
Ste 102
Charlestown, MA 02129

300 Halket St
Ste 5200
Pittsburgh, PA 15213
Phone (412) 641-7850

Interoperability endpoints

  • Direct secure messaging: tdraeger@direct.carene.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.

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1184074098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "address_2": "DIVISION OF THORACIC SURGERY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "617-525-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-736-1092",
            "fax_number": "401-738-0013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_2": "Division of Thoracic Surgery",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156106",
            "country_code": "US",
            "telephone_number": "617-525-6757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRAEGER",
        "first_name": "TYLER",
        "middle_name": "BRENDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MA",
            "license": "292835",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A160740",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "RI",
            "license": "MD19384",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdraeger@direct.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "455 Toll Gate Rd",
            "city": "Warwick",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028862759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.