Individual provider Active NPI

Tyson Don Brierley, D.O.

  • Family Medicine Physician
  • Johnson City, NY
National Provider Identifier
1194085803
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0055450 Issued in CO
Practice address
40 Arch St
Johnson City, NY 13790-2102
Phone
(607) 763-6075
Fax
(607) 763-5234
NPI assigned
May 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X DR.0055450 CO Primary

Addresses

Primary practice location

40 Arch St
Johnson City, NY 13790-2102

Mailing address

750 Warner Dr
Golden, CO 80401-5297
Phone (303) 925-4340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150814012818 CO Practitioner - Family Practice 2365672789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

2101 Ken Pratt Blvd
Suite 200
Longmont, CO 80501-6568
Phone (303) 649-3500

41 State Hwy 67
Woodland Park, CO 80863-5008
Phone (719) 776-4780

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0055450COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado CurrentSince Aug 1, 2015 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Aug 1, 2015 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

750 Warner Dr
Golden, CO 80401
Phone (303) 925-4137

11700 W 2nd Pl
Ste 210
Lakewood, CO 80228
Phone (720) 321-8080

2101 Ken Pratt Blvd
Ste 200
Longmont, CO 80501
Phone (303) 649-3500

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

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.

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": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491177600000",
    "number": "1194085803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 WARNER DR",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804015297",
            "telephone_number": "303-925-4340",
            "fax_number": "303-925-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ARCH ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902102",
            "telephone_number": "607-763-6075",
            "fax_number": "607-763-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIERLEY",
        "first_name": "TYSON",
        "middle_name": "DON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-29",
        "last_updated": "2017-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0055450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

Verify at the official NPI Registry.