Tyler Clare Nicholson, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

72278-20 Issued in WI

Practice address

5005 N. Piedras St.
William Beaumont Army Medical Center Attn: Gme
El Paso, TX 79920-5001

Phone

(915) 742-2597

Fax

(915) 742-6666

NPI assigned

Jun 20, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, ID, CA3 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 3

Specialty

Orthopedic Surgery

Education

Northeastern Ohio University College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Specialty PhysiciansGroup PAC ID 6305901927, 59 clinicians

Acute Care Surgery Medical Group IncGroup PAC ID 7214006816, 205 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
• Palestine Regional Medical Center Hospital, Palestine, TX, CCN 450747

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tyler.nicholson@direct.myhealthep.org
• Direct secure messaging: tyler.nicholson.1@20210.direct.athenahealth.com

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.

• Texas Specialty Physicians

  dba Palestine Pediatrics

  • Family Medicine Physician
  • Palestine, TX
  • NPI 1558521179

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Sacramento, CA
  • NPI 1700069549

  ID, Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Hendrick Provider Network

  • Internal Medicine Physician
  • Abilene, TX
  • NPI 1396961322
  Medicare reassignment NPD
• Surgical Affiliates of California

  • Surgery Physician
  • Los Banos, CA
  • NPI 1932440781

  ID

  Medicare reassignment NPD
• Hendrick Provider Network

  dba Hendrick Rural Health Clinic San Saba

  • Rural Health Clinic/Center
  • San Saba, TX
  • NPI 1346044401
  NPD
• Texas Specialty Physicians

  dba Palestine Medical Group: Behavioral Health

  • Psychiatry Physician
  • Palestine, TX
  • NPI 1861378168
  NPD
• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Westminster, CO
  • NPI 1477239267
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Palestine Principal Healthcare Limited Partnership

  dba Palestine Regional Medical Center

  • General Acute Care Hospital
  • Palestine, TX
  • NPI 1164510673
  Care Compare affiliation
• Palestine Principal Healthcare Limited Partnership

  dba Palestine Regional Rehabilitation Hospital

  • Rehabilitation Hospital
  • Palestine, TX
  • NPI 1326113762
  Care Compare affiliation
• St. Luke's Magic Valley Regional Medical Center, LTD.

  dba St Lukes Magic Valley - Air Ambulance

  • General Acute Care Hospital
  • Twin Falls, ID
  • NPI 1932154705
  Care Compare affiliation

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1205356482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 MEDICAL CENTER ROAD",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "614-296-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 N. PIEDRAS ST.",
            "address_2": "WILLIAM BEAUMONT ARMY MEDICAL CENTER ATTN: GME",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799205001",
            "telephone_number": "915-742-2597",
            "fax_number": "915-742-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "514 S Bonham St",
            "address_purpose": "LOCATION",
            "city": "Mexia",
            "state": "TX",
            "postal_code": "766673600",
            "country_code": "US",
            "telephone_number": "903-731-5442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4002 S Loop 256 Ste B",
            "address_purpose": "LOCATION",
            "city": "Palestine",
            "state": "TX",
            "postal_code": "758018405",
            "country_code": "US",
            "telephone_number": "903-731-5442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "TYLER",
        "middle_name": "CLARE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "U7025",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "72278-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susy Rodarte Nichols, LPC, NCC
• Trevor David Nichols, DO
• Connie Jean Nicholson, D.D.S.
• Leah Nicole Nicholson
• Melissa Nicholson, L.P.C.
• Nils P Nickel
• Mary Ann Nickerson, M.D.
• Nickes Medical Supply, LLC
• Nickes Medical Supply, LLC
• Nicolas Baida Fragoso MD PLLC

• Orthopaedic Surgery Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.