Tyler Lyle Warnecke, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10001793A Issued in IN

Practice address

7910 W Jefferson Blvd Ste 120
Fort Wayne, IN 46804-4159

Phone

(260) 435-7612

Fax

(260) 479-4618

NPI assigned

Aug 28, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Philadelphia College of Osteopathic Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lutheran Medical Group LLCGroup PAC ID 4981751617, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lutheran Hospital of Indiana Hospital, Fort Wayne, IN, CCN 150017
• Kosciusko Community Hospital Hospital, Warsaw, IN, CCN 150133

Merit-based Incentive Payment System (MIPS)

Final score

90.99 of 100Reported as apm

Quality

77.41

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tyler.warnecke@lutheranhealthnetwork.cernerdirect.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.

• Lutheran Medical Group LLC

  • Cardiovascular Disease Physician
  • Fort Wayne, IN
  • NPI 1164662805
  Medicare reassignment Care Compare group
• Lutheran Medical Group LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1710275664
  NPD
• Radiology Associates of the Main Line P C

  • Diagnostic Radiology Physician
  • Paoli, PA
  • NPI 1750332003
  NPD (past)

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

• Iom Health System LP

  • General Acute Care Hospital
  • Fort Wayne, IN
  • NPI 1306897335
  Care Compare affiliation
• Warsaw Health System LLC

  • General Acute Care Hospital
  • Warsaw, IN
  • NPI 1164475711
  Care Compare affiliation

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1245664184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6920 POINTE INVERNESS WAY STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047934",
            "telephone_number": "260-479-3514",
            "fax_number": "260-479-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 W JEFFERSON BLVD STE 120",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468044159",
            "telephone_number": "260-435-7612",
            "fax_number": "260-479-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNECKE",
        "first_name": "TYLER",
        "middle_name": "LYLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-28",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001793A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tyler.warnecke@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "7910 W Jefferson Blvd Ste 120",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Phaecia A. Ward, LCSW
• Danielle R Wardell, PSYD
• Margaret R Wardlow
• Karen Elizabeth Wardwell, PT
• Kristen A. Ware, PT
• Amanda Warner, NP
• Brad Edward Warner, DO
• Katelin Warner, DPT
• Mackenzie Warner
• Mary Kathleen Warner

• Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.