NPIMap

Individual provider Active NPI

Tyler Campbell, DO

  • Diagnostic Radiology Physician
  • Providence, RI
National Provider Identifier
1225467681
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
DO00946 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-5174
NPI assigned
Nov 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X UO3837 FL
Diagnostic Radiology Physician 2085R0202X OS15299 FL
Diagnostic Radiology Physician 2085R0202X 285531 MA
Diagnostic Radiology Physician 2085R0202X DO00946 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785

Other practice location 1

3480 NE 5th St
apt 204
Homestead, FL 33033
Phone (305) 284-7500

Other practice location 2

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone (401) 432-2520

Other practice location 3

655 W 8th St
Jacksonville, FL 32209-6511
Phone (904) 244-4282

Other practice location 4

211 Park St
Attleboro, MA 02703-3137
Phone (508) 222-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180703003147 FL Practitioner - Diagnostic Radiology 5092008045 Reassigns benefits to 1 organization
I20230712003927 CO Practitioner - Diagnostic Radiology 5092008045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Michigan State University College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penrad Imaging LLCGroup PAC ID 1850387598, 26 clinicians
Colorado Springs Radiologists PCGroup PAC ID 6901890094, 27 clinicians

Practice addresses (Care Compare)

3050 N Circle Dr
Colorado Springs, CO 80909-1175
Phone (719) 593-1799

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.1 of 100Reported as group
Quality
76.59
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
85
Improvement activities
40
Cost
76.83

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Springs Radiologists PC Diagnostic Radiology CurrentSince Jul 1, 2023 Accepting new patients
University of Florida Jacksonville Physicians Inc Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Penrad Imaging LLC CurrentSince Jul 1, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Diagnostic Radiology Current Accepting new patients
Penrad Imaging LLC CurrentSince Jul 1, 2023 Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology CurrentSince Jun 26, 2022 Accepting new patients

Locations

2222 N Nevada Ave
Colorado Springs, CO 80907
Phone (719) 776-5333

3050 N Circle Dr
Colorado Springs, CO 80909
Phone (719) 550-1200

6011 E Woodmen Rd
Ste 10
Colorado Springs, CO 80923

6001 E Woodmen Rd
Colorado Springs, CO 80923
Phone (719) 571-1000

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

593 Eddy St
Providence, RI 02903

1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500

125 Metro Center Blvd
Ste 2000
Warwick, RI 02886
Phone (401) 432-2520

Organizations & group practices 7

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 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1225467681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3480 NE 5th St",
            "address_2": "apt 204",
            "address_purpose": "LOCATION",
            "city": "Homestead",
            "state": "FL",
            "postal_code": "33033",
            "country_code": "US",
            "telephone_number": "305-284-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Metro Center Blvd Ste 2000",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028861785",
            "country_code": "US",
            "telephone_number": "401-432-2520",
            "fax_number": "401-921-9212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "655 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-4282",
            "fax_number": "904-244-4022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 Park St",
            "address_purpose": "LOCATION",
            "city": "Attleboro",
            "state": "MA",
            "postal_code": "027033137",
            "country_code": "US",
            "telephone_number": "508-222-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-06",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "UO3837",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS15299",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "285531",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "DO00946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.