Tyler R Williamson, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

A177935 Issued in CA

Practice address

85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073

Phone

(760) 924-4084

NPI assigned

Apr 10, 2017

Last updated

Aug 8, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CA

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

Specialty

Orthopedic Surgery

Education

New York University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Inyo Healthcare DistrictGroup PAC ID 8921992090, 104 clinicians

Southern Mono Health Care DistrictGroup PAC ID 9830002401, 94 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mammoth Hospital Hospital, Mammoth Lakes, CA, CCN 051303
• Northern Inyo Hospital Hospital, Bishop, CA, CCN 051324

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northern Inyo Healthcare District

  dba Northern Inyo Hospital

  • Critical Access Hospital
  • Bishop, CA
  • NPI 1922198712
  Medicare reassignment Care Compare group NPD
• Southern Mono Health Care District

  dba Mammoth Hospital

  • Critical Access Hospital Clinic/Center
  • Mammoth Lakes, CA
  • NPI 1962444059
  Medicare reassignment Care Compare group NPD
• Tahoe Orthopedics & Sports Medicine, Inc.

  • Orthopaedic Surgery Physician
  • South Lake Tahoe, CA
  • NPI 1902131287
  Medicare reassignment NPD
• Northern Inyo Associates

  • Clinic/Center
  • Bishop, CA
  • NPI 1649664848
  NPD
• Northern Inyo Healthcare District

  dba Northern Inyo Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Bishop, CA
  • NPI 1669798815
  NPD

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

• Northern Inyo Healthcare District

  dba Northern Inyo Hospital

  • Critical Access Hospital
  • Bishop, CA
  • NPI 1922198712
  Care Compare affiliation
• Southern Mono Health Care District

  dba Mammoth Hospital

  • Critical Access Hospital Clinic/Center
  • Mammoth Lakes, CA
  • NPI 1962444059
  Care Compare affiliation

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1225561939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 DAHLBERG DR STE 300",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224841",
            "telephone_number": "952-512-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SIERRA PARK RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935462073",
            "telephone_number": "760-924-4084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16800 37th Pl N",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "55446",
            "country_code": "US",
            "telephone_number": "635-207-8707",
            "fax_number": "763-520-7580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "152 Pioneer Ln Ste A",
            "address_purpose": "LOCATION",
            "city": "Bishop",
            "state": "CA",
            "postal_code": "935142563",
            "country_code": "US",
            "telephone_number": "760-873-2623",
            "fax_number": "760-873-2626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "TYLER",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-10",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "74344",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A177935",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MN",
            "license": "74344",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Watson, RN
• Bartlett White, PHYSICIAN ASSISTANT
• Clare Michelle White, FNP-C
• Cristina Dorothy Whitlock
• Robert L Willey, D.D.S.
• Lauren Wu
• Maikou Xiong
• Mark Lee Zila, DDS

• Orthopaedic Surgery Physician in Mammoth Lakes, CA
• Providers in Mammoth Lakes, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.