Individual provider Active NPI

Tyler Voegtline, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Indianapolis, IN
National Provider Identifier
1184074700
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
11018924A Issued in IN
Practice address
355 W 16TH St
#2364
Indianapolis, IN 46202-2207
Phone
(317) 963-7307
NPI assigned
Jun 14, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11018924A IN Primary

Addresses

Primary practice location

355 W 16TH St
#2364
Indianapolis, IN 46202-2207

Mailing address

355 W 16TH St
#2364
Indianapolis, IN 46202-2207

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729002308 IN Practitioner - Psychiatry 9032400031 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11018924AINMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
State of Indiana, Auditor of State CurrentSince Jun 10, 2024 Accepting new patients
State of Indiana, Auditor of State Current Accepting new patients
State of Indiana, Auditor of State CurrentSince Jun 10, 2024 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1098 S State Road 25
Logansport, IN 46947
Phone (574) 722-4141

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": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1184074700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST",
            "address_2": "#2364",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 16TH ST",
            "address_2": "#2364",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022207",
            "telephone_number": "317-963-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOEGTLINE",
        "first_name": "TYLER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11018924A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.