NPIMap

Individual provider Active NPI

Tyler James Jenkins, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Columbia, MO
National Provider Identifier
1184967218
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
2019008874 Issued in MO
Practice address
1 S Keene St
Columbia, MO 65201-7199
Phone
(573) 443-2402
Fax
(573) 443-0574
NPI assigned
Mar 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 2019008874 MO Primary
Orthopaedic Surgery Physician 207X00000X 2019008874 MO
Orthopaedic Surgery Physician 207X00000X 080288 GA
Orthopaedic Surgery Physician 207X00000X 125-062741 IL

Addresses

Primary practice location

1 S Keene St
Columbia, MO 65201-7199

Mailing address

1 S Keene St
Columbia, MO 65201-7199
Phone (573) 443-2402

Other practice location 1

676 N Saint Clair St
Suite 1350
Chicago, IL 60611-2927
Phone (312) 926-4485

Other practice location 2

59 Executive Park S Ste 3000
Atlanta, GA 30329
Phone (314) 623-4941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190613002804 MO Practitioner - Orthopedic Surgery 6204130164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Missouri, Columbia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Orthopaedic Group LLPGroup PAC ID 9335042811, 91 clinicians

Practice addresses (Care Compare)

1 S Keene St
Columbia, MO 65201-7199
Phone (573) 443-2402

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.1 of 100Reported as group
Promoting interoperability
86
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion143
Laminectomy or laminotomy (partial removal of spine bones)51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019008874MOMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Orthopaedic Group, LLP Orthopaedic Surgery CurrentSince Aug 1, 2019 Accepting new patients
Columbia Orthopaedic Group, LLP CurrentSince Aug 1, 2019 Accepting new patients

Locations

1 S Keene St
Columbia, MO 65201
Phone (573) 443-2402

Organizations & group practices 2

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 8

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": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1184967218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017199",
            "telephone_number": "573-443-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017199",
            "telephone_number": "573-443-2402",
            "fax_number": "573-443-0574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "676 N Saint Clair St",
            "address_2": "Suite 1350",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112927",
            "country_code": "US",
            "telephone_number": "312-926-4485",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "59 Executive Park S Ste 3000",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30329",
            "country_code": "US",
            "telephone_number": "314-623-4941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKINS",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-27",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MO",
            "license": "2019008874",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2019008874",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "080288",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125-062741",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.