Individual provider Active NPI

Tyler Lyman Marler, DO

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1255992905
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019021763 Issued in MO
Practice address
2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone
(314) 966-9586
Fax
(314) 966-9394
NPI assigned
Jun 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2019021763 MO Primary

Addresses

Primary practice location

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313

Mailing address

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313
Phone (314) 966-9586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20220808003115 MO Practitioner - Family Practice 9032444088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic East CommunitiesGroup PAC ID 7214827922, 573 clinicians
Aging Well Health Care, LLCGroup PAC ID 1153232038, 236 clinicians

Practice addresses (Care Compare)

300 Winding Woods Dr
Suite 222
O Fallon, MO 63366-4773
Phone (636) 256-5350

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

  • Mercy Hospice Hospice, Saint Louis, MO, CCN 261510
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • SSM Health Rehabilitation Hospital Inpatient rehabilitation facility, Richmond Heights, MO, CCN 263031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities Family Medicine CurrentSince Aug 15, 2022 Accepting new patients
Mercy Hospitals East Communities Family Medicine PastSince Aug 15, 2022 Accepting new patients

Locations

300 Winding Woods Dr
Ste 222
O Fallon, MO 63366
Phone (636) 256-5350

300 Winding Woods Dr
Ste 214
O Fallon, MO 63366
Phone (636) 281-1705

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

Organizations & group practices 3

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 4

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": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1255992905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 DOUGHERTY FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223313",
            "telephone_number": "314-966-9586",
            "fax_number": "314-966-9394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 DOUGHERTY FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223313",
            "telephone_number": "314-966-9586",
            "fax_number": "314-966-9394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLER",
        "first_name": "TYLER",
        "middle_name": "LYMAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2019021763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.