NPIMap

Individual provider Active NPI

Kelly M Tyler, MD

  • Colon & Rectal Surgery Physician
  • Springfield, MA
National Provider Identifier
1235335795
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
232267 Issued in MA
Practice address
2 Medical Center Dr
Suite 308
Springfield, MA 01107-1270
Phone
(413) 794-7020
Fax
(413) 794-2670
NPI assigned
Jun 22, 2007
Last updated
Nov 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 232267 MA
Colon & Rectal Surgery Physician 208C00000X 232267 MA Primary

Addresses

Primary practice location

2 Medical Center Dr
Suite 308
Springfield, MA 01107-1270

Mailing address

280 Chestnut St
2ND FL
Springfield, MA 01199-1001
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 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
I20070816000287 MA Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 3173615481 Reassigns benefits to 1 organization
I20251120002190 CT Practitioner - Colorectal Surgery (Proctology) 3173615481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
University of Connecticut School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

1000 Asylum Ave
Suite 4302
Hartford, CT 06105-1704
Phone (860) 714-5237

2 Medical Ctr Dr
Suite 512
Springfield, MA 01107-1273
Phone (413) 794-5550

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232267MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jan 5, 2026 Accepting new patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Jan 5, 2026 Accepting new patients
Baystate Medical Center Inc Past Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

1000 Asylum Ave
Ste 4302
West Hartford, CT 06105
Phone (860) 714-4270

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1235335795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FL",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL CENTER DR",
            "address_2": "SUITE 308",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071270",
            "telephone_number": "413-794-7020",
            "fax_number": "413-794-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "232267",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MA",
            "license": "232267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.