Individual provider Active NPI

Tyler D Zenner, MD

  • Family Medicine Physician
  • Sun Prairie, WI
National Provider Identifier
1194778704
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43642-020 Issued in WI
Practice address
10 Tower Dr
Sun Prairie, WI 53590-1239
Phone
(608) 825-3500
Fax
(608) 825-3786
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43642-020 WI Primary

Addresses

Primary practice location

10 Tower Dr
Sun Prairie, WI 53590-1239

Mailing address

10 Tower Dr
Sun Prairie, WI 53590-1239
Phone (608) 825-3500

Other identifiers 1

IdentifierTypeStateIssuer
1194778704MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address tzenner261600@direct-ehr-ssmhc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100125000841 WI Practitioner - Family Practice 4385786680 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dean Health Systems IncGroup PAC ID 7012827983, 1,174 clinicians

Practice addresses (Care Compare)

10 Tower Dr
Sun Prairie, WI 53590-1239
Phone (608) 825-3500

Hospital & facility affiliations

  • SSM Health at Home Home Health-Wisconsin Home health agency, Madison, WI, CCN 527184
  • Agrace Hospicecare Hospice, Madison, WI, CCN 521505
  • SSM Health St Mary'S Hospital - Madison Hospital, Madison, WI, CCN 520083
  • Columbus Community Hospital Hospital, Columbus, WI, CCN 521338

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal or shaving of skin growth1-10
Skin biopsy17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43642-020WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince Aug 8, 2001 Accepting new patients
Dean Health Systems, Inc Family Medicine CurrentSince Aug 8, 2001 Accepting new patients
Stoughton Hospital Association CurrentSince Jan 1, 2026 Accepting new patients
Stoughton Hospital Association CurrentSince Jan 1, 2026 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

10 Tower Dr
Sun Prairie, WI 53590
Phone (608) 825-3008

Interoperability endpoints

  • Direct secure messaging: tzenner261600@direct-ehr-ssmhc.com

Organizations & group practices 5

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 6

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1194778704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TOWER DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901239",
            "telephone_number": "608-825-3500",
            "fax_number": "608-825-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 TOWER DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901239",
            "telephone_number": "608-825-3500",
            "fax_number": "608-825-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENNER",
        "first_name": "TYLER",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "43642-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194778704",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "10 Tower Dr",
            "city": "Sun Prairie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535901239",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tzenner261600@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tzenner261600@direct-ehr-ssmhc.com",
            "address_1": "10 Tower Dr",
            "city": "Sun Prairie",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535901239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sun Prairie, WI

Sources for this page

Verify at the official NPI Registry.